Search › Georgia › 122300000X
Jackson Fordham, DMD
NPI 1699858001 · on the registry since 2006 · sole proprietor
Practice
- Address
- 204 Fairview Park Dr
Dublin, GA 31021 - Phone
- (478) 272-4051
- Fax
- (478) 272-3310
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-06-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia