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1598258501
DANIEL THOMAS DOHERTY
SAINT LOUIS, MO
NPI
1598258501
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: MO 2018019124)
Enumeration Date
2018-06-13
Last Update Date
2018-06-13
Business Address
DANIEL THOMAS DOHERTY
621 S NEW BALLAS RD # 10
SAINT LOUIS, MO 63141-8232
Phone number: 314-251-5775
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Mailing Address
DANIEL THOMAS DOHERTY
621 S NEW BALLAS RD # 10
SAINT LOUIS, MO 63141-8232
Phone number: 314-251-5775
Copy
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