Individual
DR. GARY CORNFORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
406 1ST AVE N, JAMESTOWN, ND 58401-3302
(701) 252-7050
(701) 251-1286
Mailing address
406 1ST AVE N, JAMESTOWN, ND 58401-3302
(701) 252-7050
(701) 251-1286
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1504C
ND
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
D11388
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41403
—
ND
Enumeration date
04/11/2007
Last updated
07/08/2007
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