Most Relevant Information
Provider Data
| NPI Number: | 1003077108 |
| Provider Name: | S ADELE DOHERTY |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 4679 |
Most Important Dates
| Enumeration Date: | 06/20/2008 |
| Last Updated: | 06/20/2008 |
Provider Practice Location
107 NEW BRICK CHURCH PIKE
SUITE C
GOODLETTSVILLE
TN
370721545
Practice Location Phone/Fax
| Phone: | 6158514744 |
| Fax: |
Provider Mailing Location
PO BOX 646
MOUNT JULIET
TN
371210646
Provider Mailing Phone/Fax
| Phone: | 6158514744 |
| Fax: |