Individual
JOSEPH ALAN DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
500 CENTRAL RD, NEW LENOX, IL 60451-3308
(815) 931-1984
Mailing address
500 CENTRAL RD, NEW LENOX, IL 60451-3308
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
LL-424-16
NV
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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