Organization
MARK A. DOUGHERTY, D.D.S., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A DOUGHERTY D.D.S. (PRESIDENT)
(714) 993-1194
Entity
Organization
Contact information
Practice address
17300 YORBA LINDA BLVD STE H, YORBA LINDA, CA 92886-3810
(714) 993-1194
(714) 524-0397
Mailing address
17300 YORBA LINDA BLVD STE H, YORBA LINDA, CA 92886-3810
(714) 993-1194
(714) 524-0397
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
03/26/2007
Last updated
08/22/2020
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