Cornforth, Gary

Cornforth, Gary is an sole proprietor health care provider with primary practice located at 406 1St Ave N , Jamestown ND 58401-3302. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Cornforth, Gary can be contacted via phone (701) 252-7050.

Contact Information

Primary practice address
406 1St Ave N Jamestown ND 58401-3302
Phone: (701) 252-7050
Fax: (701) 251-1286
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 1504C North Dakota
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X D11388 Minnesota

Profile Details

NPI number 1295958890
LBN Legal business name Cornforth, Gary
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 11th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295958890 NPPES
North Dakota MEDICAID 41403

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