Individual
DR. JACKSON D FORDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
204 FAIRVIEW PARK DR, DUBLIN, GA 31021-2547
(478) 272-4051
(478) 272-3310
Mailing address
204 FAIRVIEW PARK DR, DUBLIN, GA 31021-2547
(478) 272-4051
(478) 272-3310
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9503
GA
Other
Enumeration date
10/23/2006
Last updated
06/20/2016
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