DR. Theodore Michael Dougherty, D.D.S.

NPI #1760767958 in Olney, Maryland

Provider Information

NPI Number: 1760767958
Entity Type: Individual
Name: DR. Theodore Michael Dougherty, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Oct 19, 2011
Last Updated: Oct 19, 2011

Practice Location

Address: 18121 GEORGIA AVE
Address 2: SUITE 110
City: Olney
State: Maryland
ZIP Code: 20832-1437
Phone: (240) 390-0276

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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