Individual provider · Type 1 NPI

Connor Thomas Doherty, DDS

Student in an Organized Health Care Education/Training Program · Lexington, KY

NPI number 1790472207 Active

Practice location

770 Rose Street
Lexington, KY 40536-0001

Mailing address

567 S Sierra Ave Unit 75
Solana Beach, CA 92075-2238

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1790472207

Connor Thomas Doherty, DDS's National Provider Identifier is 1790472207, issued on Apr 24, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Lexington, KY. The record was last updated on Apr 24, 2023.