Provider Demographics
NPI:1992200448
Name:FORD'S FAMILY DENTISTRY
Entity Type:Organization
Organization Name:FORD'S FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-591-8325
Mailing Address - Street 1:6 61ST STREET NORTH
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35212
Mailing Address - Country:US
Mailing Address - Phone:205-591-8325
Mailing Address - Fax:205-591-8324
Practice Address - Street 1:6 61ST STREET NORTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35212
Practice Address - Country:US
Practice Address - Phone:205-591-8325
Practice Address - Fax:205-591-8324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4297122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty