NPI 1629730015

Brejaun D Ford

Practitioner Dental Assistant Coral Springs, FL

Practice location

Address: 2801 N University Dr STE 202, Coral Springs, FL 33065-5053
Phone: (954) 688-6888
Mailing address: 3555 W Atlantic Blvd APT 507, Pompano Beach, FL 33069-2574

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X Licence 257571 (FL)

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Registry record

NPI: 1629730015
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Oct 2021
Record last updated: 12 Oct 2021

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.