Individual
DR. JENNIFER PSOTA DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
7123 PEARL RD, SUITE 100, CLEVELAND, OH 44130-4975
(440) 888-6783
Mailing address
2255 COLUMBIA RD, WESTLAKE, OH 44145-4102
(440) 835-0011
(440) 250-1896
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
21039
OH
Other
Enumeration date
07/21/2006
Last updated
10/05/2012
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