Organization
DOHERTY FAMILY DENTAL, LLC
Active
Other names
Brentwood Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL THOMAS DOHERTY D.D.S. (OWNER)
(314) 596-8974
Entity
Organization
Contact information
Practice address
8824 LITZSINGER RD, BRENTWOOD, MO 63144-2222
(314) 961-3221
(314) 961-7477
Mailing address
8824 LITZSINGER RD, BRENTWOOD, MO 63144-2222
(314) 961-3221
(314) 961-7477
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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