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Individual

DR. HENRY C FORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
181 ACADEMY ST STE 1, PRESQUE ISLE, ME 04769-3178
(207) 764-6337
(207) 764-1446
Mailing address
181 ACADEMY ST STE 1, PRESQUE ISLE, ME 04769-3178
(207) 764-6337
(207) 764-1446

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
3224
NH
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3426
ME
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
DEN3426
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
037356
BLUE CROSS
ME
05
132730000
ME
01
2209645
AETNA
ME
01
9760835
CIGNA
ME
Enumeration date
12/15/2006
Last updated
01/23/2014
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