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General NPI Number Information
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NPI Number | 1801011911
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Entity Type | Organization
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Legal Business Name | KENNETH C. FORDHAM, JR.
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 241 BYERS RD
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City | CHESTER SPRINGS
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State | PA
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Zip | 19425
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Country | US
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Telephone | 610-458-3800
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Fax | 610-458-3904
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Provider Business Mailing Address
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Address Line | 241 BYERS RD
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City | CHESTER SPRINGS
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State | PA
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Zip | 19425
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Country | US
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Telephone | 610-458-3800
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Fax | 610-458-3904
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENNETH C FORDHAM JR.
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Credential | DMD
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Telephone | 610-458-3800
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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 | DS023116L
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License Number State | PA
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