Kevin P. Dougherty, DMD, PA
Organization Active NPI General Practice Dentistry · Chatham, NJ
NPI 1104949064 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1104949064
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D15205 (NJ)
- Legal business name
- KEVIN P. DOUGHERTY, DMD, PA
- Practice address
- 475 Shunpike Rd
Chatham, NJ 07928-1528 - Phone
- (973) 377-3000
- Fax
- (973) 377-0909
- NPI assigned
- Apr 7, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Kevin Paul Dougherty, DMD
- Title
- President
- Phone
- (973) 377-3000
Practitioners 2
-
Blake Edward Bandeff, DMD
-
Kevin Paul Dougherty, DMD
National Provider Directory
Locations
475 Shunpike Rd
Chatham, NJ 07928
Phone (973) 377-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | D15205 | NJ | Yes |
Addresses
Primary practice location
475 Shunpike Rd
Chatham, NJ 07928-1528
Mailing address
475 Shunpike Rd
Chatham, NJ 07928-1528
Phone (973) 377-3000
Other providers in Chatham, NJ
- Cheryl Kaulback
- Amy Lynn Kearns
- Julia Keegan
- Margot I Kerrigan
- Kessler Pediatric Therapy, Inc.
- Yoshiko Kinoshita
- Brittany Anne Klimek
- Cathy S Kneese
- Brian Knudsen
- Gabrielle M Kokich
All providers in Chatham, NJ · General Practice Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.