| Tyler Fordham Dds Pllc | |
|
1233 W Sims Way Port Townsend WA 98368-3057 | |
| (360) 349-4001 | |
| Not Available |
| Full Name | Tyler Fordham Dds Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1233 W Sims Way, Port Townsend, Washington |
| Authorized Official Name and Position | Tyler Alan Fordham (OWNER) |
| Authorized Official Contact | 3603494001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tyler Fordham Dds Pllc 82 Masonic Hall Rd Port Hadlock WA 98339-9567 Ph: (360) 349-4001 | Tyler Fordham Dds Pllc 1233 W Sims Way Port Townsend WA 98368-3057 Ph: (360) 349-4001 |
| NPI Number | 1508126491 |
|---|---|
| Provider Enumeration Date | 05/24/2012 |
| Last Update Date | 05/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508126491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE60212723 (Washington) | Primary |
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