Individual
DR. LARRY EDMOND DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
305 ESTILL STREET, BEREA HOSPITAL, BEREA, KY 40403
(859) 986-6511
Mailing address
305 ESTILL STREET, BEREA HOSPITAL, BEREA, KY 40403
(859) 986-6511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5160
KY
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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