Gary Cornforth

NPI 1013326768 - Clinic/Center - 261QD0000X

NPI Details
NPI 1013326768
Enumeration Date 08/07/2014
Last Updated 08/07/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name GARY GARY
Position ORTHODONTIST
Phone (701) 232-1500
Fax (701) 293-6969
Practice Location
2534 UNIVERSITY DR S
SUITE #6
FARGO ND, 58103-5700, US
Phone (701) 232-1500
Fax (701) 293-6969
Business Location
2534 UNIVERSITY DR S
SUITE #6
FARGO ND, 58103-5700, US
Phone (701) 232-1500
Fax (701) 293-6969
Toxanomy
Taxonomy Code 261QD0000X
License State North Dakota
License Number 1504C
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According to our database, Gary Cornforth NPI is 1013326768, taxonomy code is 261QD0000X and license number is 1504C, license state is located at North Dakota. Gary Cornforth physically located at 2534 University Dr S, Fargo ND, 58103-5700. NPI Number 1033115704 has the healthcare provider type.

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1013326768 NPI number is provided on an as is basis without warranty of any kind. 1013326768 is maintained by the National Plan & Provider Enumeration System. The contents of Gary Cornforth are for informational purposes only.