Individual
JASON EDWARD FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2533 LARKIN RD, SUITE 101, LEXINGTON, KY 40503-3278
(859) 278-9376
Mailing address
2533 LARKIN RD, SUITE 101, LEXINGTON, KY 40503-3278
(859) 278-9376
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
7857
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
7857
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100039960
—
KY
05
—
7100039980
—
KY
Enumeration date
03/06/2008
Last updated
02/08/2016
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