Provider Demographics
NPI:1821817180
Name:GAUTHIER ORTHODONTICS PLLC
Entity type:Organization
Organization Name:GAUTHIER ORTHODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GAUTHIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:906-399-0342
Mailing Address - Street 1:730 N CROOKS RD
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-3010
Mailing Address - Country:US
Mailing Address - Phone:248-435-2000
Mailing Address - Fax:
Practice Address - Street 1:730 N CROOKS RD
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-3010
Practice Address - Country:US
Practice Address - Phone:248-435-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty