Individual
DR. MICHAEL SHANNON DAUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1805 W MAIN ST, SUITE 3, DOTHAN, AL 36301-1343
(334) 699-3636
(334) 699-3637
Mailing address
200 GROVE PARK LN, SUITE 600, DOTHAN, AL 36305-5911
(334) 699-3636
(334) 699-3637
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
AL-4912
AL
Other
Enumeration date
06/03/2006
Last updated
05/18/2011
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