Provider Demographics
NPI:1457465304
Name:FORD, FLOYD NORMAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:NORMAN
Last Name:FORD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-1513
Mailing Address - Country:US
Mailing Address - Phone:662-327-5533
Mailing Address - Fax:
Practice Address - Street 1:2900 BLUECUTT RD
Practice Address - Street 2:SUITE 4
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-1470
Practice Address - Country:US
Practice Address - Phone:662-329-1555
Practice Address - Fax:662-329-2771
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS26741223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics