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Contact Information

LARRY D DAUGHERTY, DMD
124 ISLAND PROFESSIONAL PARK
SAINT SIMONS ISLAND, GA31522
 Phone: 912-434-4121
 Fax: 912-268-2847
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for LARRY D DAUGHERTY · (Male)

NPI Number 1053493486
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 10/19/2006
Last updated 02/24/2017 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # 10020
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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