NPI 1013055300
Rick M Dougherty, DDSABGDNDBA
Practice location
- Address
- 18301 N 79th Ave G-185, Glendale, AZ 85308-8463
- Phone
- (623) 931-9197
- Fax
- (623) 937-4385
Registered specialties
General Practice Dentistry
Primary
Registry record
- NPI
- 1013055300
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 1 Feb 2007
- Record last updated
- 1 Oct 2012
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.