# TYLER FORDHAM DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508126491
- **Authorized official:** DR. TYLER ALAN FORDHAM DDS (OWNER)
- **Authorized official phone:** (360) 349-4001

## Contact information

- **Practice address:** 1233 W SIMS WAY, PORT TOWNSEND, WA 98368-3057
- **Practice address phone:** (360) 349-4001
- **Mailing address:** 82 MASONIC HALL RD, PORT HADLOCK, WA 98339-9567
- **Mailing address phone:** (360) 349-4001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE60212723 | WA | Yes |

## Other

- **Enumeration date:** 05/24/2012
- **Last updated:** 05/24/2012