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General NPI Number Information
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NPI Number | 1457692238
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Entity Type | Organization
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Legal Business Name | FORD & ASSOCIATES FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 03/05/2013
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 115 E FLAGET ST
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City | BARDSTOWN
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State | KY
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Zip | 40004-1517
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Country | US
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Telephone | 502-348-9400
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Fax | 502-348-9520
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Provider Business Mailing Address
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Address Line | 115 E FLAGET ST
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City | BARDSTOWN
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State | KY
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Zip | 40004-1517
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Country | US
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Telephone | 502-348-9400
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Fax | 502-348-9520
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JASON ANTHONY FORD
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Credential | D.M.D.
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Telephone | 502-348-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9028
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License Number State | KY
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