Individual
KEVIN D. DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
8453 NASHVILLE RD, BOWLING GREEN, KY 42101-8721
(270) 707-0292
Mailing address
727 US 31W BYP STE 101, BOWLING GREEN, KY 42101-4963
(270) 783-5280
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9368
NC
1223G0001X
General Practice Dentistry
Primary
10315
KY
Other
Enumeration date
10/10/2012
Last updated
08/14/2023
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