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Organization
KELLY W. FORD, D.M.D, MH. SPA
Active
Organization
KELLY W. FORD, D.M.D, MH. SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY W FORD DMD (OWNER)
(843) 871-6636
Entity
Organization
Contact information
Practice address
321 N LAUREL ST, SUMMERVILLE, SC 29483
(843) 871-6636
Mailing address
321 N LAUREL ST, SUMMERVILLE, SC 29483
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
1790
SC
1223P0300X
Periodontics
3045
SC
Other
Enumeration date
07/19/2005
Last updated
08/22/2020
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