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Organization

KIMBERLY MARIE FORD, DDS, LLC

Active
Other names
Ellicott Mills Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KIMBERLY MARIE FORD DDS (OWNER)
(443) 867-4928
Entity
Organization

Contact information

Practice address
3505 ELLICOTT MILLS DR STE B2, ELLICOTT CITY, MD 21043-4578
(410) 461-3311
(410) 750-7348
Mailing address
3505 ELLICOTT MILLS DR STE B2, ELLICOTT CITY, MD 21043-4578
(410) 461-3311
(410) 750-7348

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1023397502
NPI
MD
Enumeration date
12/28/2018
Last updated
12/28/2018
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