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General NPI Number Information
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NPI Number | 1477685071
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Entity Type | Organization
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Legal Business Name | FORD ORTHODONTICS LTD
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 09/24/2007
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Provider Practice Location Address
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Address Line | 585 LINCOLN AVE
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City | WINNETKA
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State | IL
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Zip | 60093-2351
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Country | US
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Telephone | 847-446-2245
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Fax | 847-446-2254
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Provider Business Mailing Address
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Address Line | 585 LINCOLN AVE
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City | WINNETKA
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State | IL
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Zip | 60093-2351
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Country | US
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Telephone | 847-446-2245
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Fax | 847-446-2254
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. JOHN C FORD
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Credential | D.M.D.,M.S.
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Telephone | 847-446-2245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State | IL
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