Organization
FORD & DRAPER DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN G. FORD D.D.S. (OWNER)
(801) 475-6500
Entity
Organization
Contact information
Practice address
1508 E SKYLINE DR, SUITE 400, SOUTH OGDEN, UT 84405-4846
(801) 475-6500
(801) 479-5904
Mailing address
1508 E SKYLINE DR, SUITE 400, SOUTH OGDEN, UT 84405-4846
(801) 475-6500
(801) 479-5904
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529356730001
—
UT
05
—
529356756000
—
UT
Enumeration date
05/21/2007
Last updated
08/22/2020
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