Individual
THOMAS PATRICK DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5317 LIMESTONE RD, WILMINGTON, DE 19808-1252
(302) 239-2500
(302) 239-0550
Mailing address
5317 LIMESTONE RD, WILMINGTON, DE 19808-1035
(302) 239-2500
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
G10000905
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000912501
—
DE
01
—
54490
AETNA
CT
Enumeration date
12/20/2006
Last updated
08/13/2008
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