| William J Doherty, Dds, Pc | |
|
120 Herrick Park Dr Tecumseh MI 49286-1422 | |
| (517) 423-4050 | |
| (517) 424-6363 |
| Full Name | William J Doherty, Dds, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 Herrick Park Dr, Tecumseh, Michigan |
| Authorized Official Name and Position | William J Doherty (OWNER) |
| Authorized Official Contact | 5174234050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| William J Doherty, Dds, Pc 120 Herrick Park Dr Tecumseh MI 49286-1422 Ph: (517) 423-4050 | William J Doherty, Dds, Pc 120 Herrick Park Dr Tecumseh MI 49286-1422 Ph: (517) 423-4050 |
| NPI Number | 1548800873 |
|---|---|
| Provider Enumeration Date | 01/15/2020 |
| Last Update Date | 01/15/2020 |
| Medicare PECOS PAC ID | 7113352220 |
|---|---|
| Medicare Enrollment ID | O20210112002842 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548800873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | William J Doherty |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1801235270 PECOS PAC ID: 6204141302 Enrollment ID: I20210115000065 |
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