NPI 1003115841

Tyler Alan Fordham, DDS

Practitioner Dentist Yakima, WA

Practice location

Address: 407 N 63rd Ave, Yakima, WA 98908-2707
Phone: (509) 823-1087

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence DE60212723 (WA)

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Registry record

NPI: 1003115841
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Mar 2011
Record last updated: 18 Mar 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.