Individual
DR. LARRY D. DAUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
124 ISLAND PROFESSIONAL PARK, ST SIMONS ISLAND, GA 31522
(912) 434-4121
(912) 268-2847
Mailing address
124 ISLAND PROFESSIONAL PARK, ST SIMONS ISLAND, GA 31522-2879
(912) 434-4121
(912) 268-2847
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10020
GA
Other
Enumeration date
10/19/2006
Last updated
02/24/2017
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