Provider Demographics
NPI:1104290451
Name:WILLIAM V DOUGHERTY III DDS PLC
Entity type:Organization
Organization Name:WILLIAM V DOUGHERTY III DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:DOUGHERTY
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-532-3300
Mailing Address - Street 1:200 LITTLE FALLS ST
Mailing Address - Street 2:SUITE 506
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4302
Mailing Address - Country:US
Mailing Address - Phone:703-532-3300
Mailing Address - Fax:703-532-3302
Practice Address - Street 1:200 LITTLE FALLS ST
Practice Address - Street 2:SUITE 506
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4302
Practice Address - Country:US
Practice Address - Phone:703-532-3300
Practice Address - Fax:703-532-3302
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POTOMAC VALLEY DENTAL CARE, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty