Gaudry, Derek Adam
Gaudry, Derek Adam is an individual health care provider with primary practice located at 2018 Army Blvd, Apt A Usa Dentac, Ft Sam Houston TX 78234. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Endodontics. Dental Providers / Endodontics is his primary health care specialty. Gaudry, Derek Adam can be contacted via phone (210) 221-0826.Contact Information
Primary practice address
2018 Army Blvd, Apt A Usa Dentac
Ft Sam Houston TX 78234
Phone: (210) 221-0826
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Dentist | 122300000X | 105 | South Dakota |
Dental Providers / Endodontics | 1223E0200X | D0521 | South Dakota |
Profile Details
NPI number | 1225002652 |
---|---|
LBN Legal business name | Gaudry, Derek Adam |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 14th, 2006 |
Last updated | Jun 19th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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