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NPI Code Detail

MEDICARE: ROBERT DOHERTY DDS

MEDICARE: ROBERT DOHERTY DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry6815NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881663383
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT DOHERTY DDS
Provider Business Mailing Address
First Line : 7 PROFESSIONAL DR
Second Line :
City : SNOW HILL
State : NC
Zip : 28580-1332
Country : US
Telephone Number : 252-747-8162
Fax Number : 252-747-8163
Provider Business Practice Location Address
First Line : 6 PROFESSIONAL DR
Second Line :
City : SNOW HILL
State : NC
Zip : 28580-1333
Country : US
Telephone Number : 252-747-3846
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 02/01/2023

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Directions to “ ROBERT DOHERTY DDS” Practice Location

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