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MICHAEL DENNIS DOHERTY D.D.S.

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1114097482

Individual Registrant:
 MICHAEL DENNIS DOHERTY D.D.S.
Gender: M
Sole Proprietor

Location and contact information for practice:
580 MAIN ST SUITE 200 CARBONDALE, CO 81623-2072 US
Tel: 970-963-4882  Fax: 970-963-1023

Contact information for business:
580 MAIN ST SUITE 200 CARBONDALE, CO 81623-2072 US
Tel: 970-963-4882  Fax: 970-963-1023

Registration Information:
NPI: 1114097482
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
CO6715

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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