Individual
DR. RANDALL L FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1740 BIG SPRINGS RD, MARYVILLE, TN 37801-8206
(865) 681-7645
(865) 681-3488
Mailing address
1740 BIG SPRINGS RD, MARYVILLE, TN 37801-8206
(865) 681-7645
(865) 681-3488
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS5205
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DS5205
1649345406
TN
Enumeration date
05/05/2008
Last updated
10/05/2016
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