Organization
THOMAS P DOUGHERTY ORAL MAXILLOFACIAL SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS P DOUGHERTY (ORAL MAXILLOFACIAL SURGEON)
(302) 239-2500
Entity
Organization
Contact information
Practice address
5317 LIMESTONE RD, WILMINGTON, DE 19808-1252
(302) 239-2500
(302) 239-0552
Mailing address
5317 LIMESTONE RD, WILMINGTON, DE 19808-1252
(302) 239-2500
(302) 239-0552
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000912501
—
DE
01
—
54490
AETNA
DE
Enumeration date
04/10/2008
Last updated
08/04/2008
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