Dr. Brian P. Ford, D.M.D., M.D.
Oral & Maxillofacial Surgery in Philadelphia, PA. Individual provider (NPI-1).
NPI number1578799862
StatusActive
Last updated in NPPESSep 26, 2019
Details
- NPI
- 1578799862
- Entity type
- Individual (NPI-1)
- Name
- Dr. Brian P. Ford
- Credential
- D.M.D., M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 2, 2009
- Last updated
- Sep 26, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 204E00000X | Oral & Maxillofacial Surgery | MD456122 | PA | Yes |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | DS037873 | PA | |
| 204E00000X | Oral & Maxillofacial Surgery | DS037873 | PA |
Practice location
3400 Civic Center Blvd4th Floor, South Pavilion
Philadelphia, PA 19104-5127
Phone 215-662-3580
Mailing address
3400 Civic Center Blvd4th Floor, South Pavilion
Philadelphia, PA 19104-5127
Phone 215-662-3580
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