Provider Demographics
NPI:1487044939
Name:FORD ORTHODONTICS, P.A.
Entity Type:Organization
Organization Name:FORD ORTHODONTICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:352-368-9099
Mailing Address - Street 1:1800 SE 17TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4191
Mailing Address - Country:US
Mailing Address - Phone:352-368-9099
Mailing Address - Fax:352-368-9791
Practice Address - Street 1:1800 SE 17TH ST
Practice Address - Street 2:SUITE 500
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4191
Practice Address - Country:US
Practice Address - Phone:352-368-9099
Practice Address - Fax:352-368-9791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0090521223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty