Provider Demographics
NPI:1477685071
Name:FORD ORTHODONTICS LTD
Entity Type:Organization
Organization Name:FORD ORTHODONTICS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD,MS
Authorized Official - Phone:847-446-2245
Mailing Address - Street 1:585 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2351
Mailing Address - Country:US
Mailing Address - Phone:847-446-2245
Mailing Address - Fax:847-446-2254
Practice Address - Street 1:585 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-2351
Practice Address - Country:US
Practice Address - Phone:847-446-2245
Practice Address - Fax:847-446-2254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty