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Individual

DR. EDWARD T DOUGHERTY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
12308 OCEAN GTWY, OCEAN CITY, MD 21842-9341
(410) 213-1482
Mailing address
36872 JAHNIGEN DR, FRANKFORD, DE 19945-4590
(410) 213-1482

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
G1-0001178
DE
1223G0001X
General Practice Dentistry
Primary
MD6401
MD

Other

Enumeration date
02/01/2012
Last updated
02/01/2012
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