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Individual

DR. BRENT STEWART FORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
BLDG H 2005 KNIGHT LANE, NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS, JACKSONVILLE, FL 32212-0140
(760) 725-3213
Mailing address
BLDG H 2005 KNIGHT LANE, NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS, JACKSONVILLE, FL 32212-0140
(760) 725-3213

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21556
FL

Other

Enumeration date
08/24/2015
Last updated
08/31/2015
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