Organization
PAUL M. DOUGHTY D.M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL MARTIN DOUGHTY D.M.D. (OWNER/DENTIST)
(843) 766-0610
Entity
Organization
Contact information
Practice address
18 LEINBACH DR STE A, CHARLESTON, SC 29407-7916
(843) 766-0610
Mailing address
18 LEINBACH DR STE A, CHARLESTON, SC 29407-7916
(843) 766-0610
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4375
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2X4375
—
SC
Enumeration date
03/25/2011
Last updated
03/25/2011
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