Individual
DR. MATTHEW STEVEN DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-5857
Mailing address
2506 MONICA LN, BLOOMINGTON, IL 61705-4131
(205) 343-4686
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901020200
MI
Other
Enumeration date
06/23/2010
Last updated
03/23/2022
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