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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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 10 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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