| Doherty Family Dental, Llc | |
|
8824 Litzsinger Rd Brentwood MO 63144-2222 | |
| (314) 961-3221 | |
| (314) 961-7477 |
| Full Name | Doherty Family Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8824 Litzsinger Rd, Brentwood, Missouri |
| Authorized Official Name and Position | Daniel Thomas Doherty (OWNER) |
| Authorized Official Contact | 3145968974 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Doherty Family Dental, Llc 8824 Litzsinger Rd Brentwood MO 63144-2222 Ph: (314) 961-3221 | Doherty Family Dental, Llc 8824 Litzsinger Rd Brentwood MO 63144-2222 Ph: (314) 961-3221 |
| NPI Number | 1730776345 |
|---|---|
| Provider Enumeration Date | 12/29/2020 |
| Last Update Date | 12/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730776345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Missouri College, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1405 S Hanley Rd, Brentwood, MO 63144 Phone: 314-768-7800 Fax: 314-768-7900 |