Individual
DR. JEFF M DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
2726 HIGHWAY K, O FALLON, MO 63368-7884
(636) 272-5015
Mailing address
643 AVONDALE DR, SAINT PETERS, MO 63376-7711
(636) 294-3090
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2004020376
MO
Other
Enumeration date
12/18/2006
Last updated
07/08/2007
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