Organization
TYLER FORDHAM DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER ALAN FORDHAM DDS (OWNER)
(360) 349-4001
Entity
Organization
Contact information
Practice address
1233 W SIMS WAY, PORT TOWNSEND, WA 98368-3057
(360) 349-4001
Mailing address
82 MASONIC HALL RD, PORT HADLOCK, WA 98339-9567
(360) 349-4001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60212723
WA
Other
Enumeration date
05/24/2012
Last updated
05/24/2012
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