Provider Demographics
NPI:1093710931
Name:BUMFORD, JAMES MACK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MACK
Last Name:BUMFORD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19994 FARMINGTON RD
Mailing Address - Street 2:STE D-3
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1409
Mailing Address - Country:US
Mailing Address - Phone:248-477-8505
Mailing Address - Fax:248-615-0920
Practice Address - Street 1:19994 FARMINGTON RD
Practice Address - Street 2:STE D-3
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1409
Practice Address - Country:US
Practice Address - Phone:248-477-8505
Practice Address - Fax:248-615-0920
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI11463122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist