Individual
MS. CARLA DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5471 DR MARTIN LUTHER KING DR, ST LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Mailing address
5471 DR MARTIN LUTHER KING DR, ST LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2003002706
MO
Other
Enumeration date
05/01/2006
Last updated
02/04/2013
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