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General NPI Number Information
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NPI Number | 1134695067
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Entity Type | Organization
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Legal Business Name | KEVIN D. DAUGHERTY, DMD AND SAVANNAH H. DAUGHERTY, DMD, PA
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Dates
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Enumeration Date | 10/18/2018
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1700 OLD VILLAGE RD
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City | HENDERSONVILLE
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State | NC
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Zip | 28791-3736
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Country | US
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Telephone | 828-693-5190
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Fax | 828-595-9104
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Provider Business Mailing Address
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Address Line | 1700 OLD VILLAGE RD
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City | HENDERSONVILLE
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State | NC
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Zip | 28791-3736
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Country | US
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Telephone | 828-693-5190
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Fax | 828-595-9104
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Authorized Official
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Title or Position | CO OWNER
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Name | SAVANNAH DAUGHERTY
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Credential | DMD
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Telephone | 828-693-5190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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