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Individual

DR. MICHAEL D FORDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS, MS

Contact information

Practice address
2350 PROFESSIONAL DR, 100, ROSEVILLE, CA 95661-7747
(916) 783-0122
(916) 783-6127
Mailing address
2350 PROFESSIONAL DR, 100, ROSEVILLE, CA 95661-7747
(916) 783-0122
(916) 783-6127

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
56398
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
670975300
MN
Enumeration date
01/10/2006
Last updated
06/09/2008
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