| Mark A. Dougherty, D.d.s., Inc | |
|
17300 Yorba Linda Blvd Ste H Yorba Linda CA 92886-3810 | |
| (714) 993-1194 | |
| (714) 524-0397 |
| Full Name | Mark A. Dougherty, D.d.s., Inc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 17300 Yorba Linda Blvd Ste H, Yorba Linda, California |
| Authorized Official Name and Position | Mark A Dougherty (PRESIDENT) |
| Authorized Official Contact | 7149931194 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark A. Dougherty, D.d.s., Inc 17300 Yorba Linda Blvd Ste H Yorba Linda CA 92886-3810 Ph: (714) 993-1194 | Mark A. Dougherty, D.d.s., Inc 17300 Yorba Linda Blvd Ste H Yorba Linda CA 92886-3810 Ph: (714) 993-1194 |
| NPI Number | 1164540696 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164540696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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