| Thomas P Dougherty Oral Maxillofacial Surgery Pa | |
|
5317 Limestone Rd Wilmington DE 19808-1252 | |
| (302) 239-2500 | |
| (302) 239-0552 |
| Full Name | Thomas P Dougherty Oral Maxillofacial Surgery Pa |
|---|---|
| Speciality | Dentist |
| Location | 5317 Limestone Rd, Wilmington, Delaware |
| Authorized Official Name and Position | Thomas P Dougherty (ORAL MAXILLOFACIAL SURGEON) |
| Authorized Official Contact | 3022392500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas P Dougherty Oral Maxillofacial Surgery Pa 5317 Limestone Rd Wilmington DE 19808-1252 Ph: (302) 239-2500 | Thomas P Dougherty Oral Maxillofacial Surgery Pa 5317 Limestone Rd Wilmington DE 19808-1252 Ph: (302) 239-2500 |
| NPI Number | 1245403286 |
|---|---|
| Provider Enumeration Date | 04/10/2008 |
| Last Update Date | 08/04/2008 |
| Medicare PECOS PAC ID | 8022188655 |
|---|---|
| Medicare Enrollment ID | O20080609000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245403286 | NPI | - | NPPES |
| 0000912501 | Medicaid | DE | |
| 54490 | Other | DE | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Thomas Dougherty |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1043374515 PECOS PAC ID: 8921178559 Enrollment ID: I20080609000253 |
Kirkwood Dental Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 Greenbank Rd, Wilmington, DE 19808 Phone: 302-994-2582 Fax: 302-994-5151 | |
Hockessin Smile Studio, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5341 Limestone Rd, Wilmington, DE 19808 Phone: 443-593-5479 | |
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