Organization
JEFF FORDICE DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF FORDICE DDS (OWNER)
(507) 238-4276
Entity
Organization
Contact information
Practice address
1120 BIRCH ST, FAIRMONT, MN 56031-4418
(507) 238-4276
Mailing address
1120 BIRCH ST, FAIRMONT, MN 56031-4418
(507) 238-4276
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9297
MN
Other
Enumeration date
01/03/2012
Last updated
01/03/2012
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