Individual
CONNOR THOMAS DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
770 ROSE STREET, LEXINGTON, KY 40536-0001
(859) 323-6080
Mailing address
567 S SIERRA AVE UNIT 75, SOLANA BEACH, CA 92075-2238
(917) 536-6518
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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