Individual
DR. WARREN FREDERICK DAUGHERTY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
207 HATHAWAY PARK, LEBANON, PA 17042-6163
(717) 273-0411
(717) 272-7099
Mailing address
207 HATHAWAY PARK, LEBANON, PA 17042-6163
(717) 273-0411
(717) 272-7099
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D5015609L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1156932
MET LIFE
—
01
—
59606
UNITED CONCORDIA
—
Enumeration date
09/01/2006
Last updated
07/08/2007
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