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Provider Information for 1700191533

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

COLIN A FORDE DDS

Gender: MALE

Individual NPI: 1700191533

Calendar   Last Updated:  2021-04-27
  Certification Date:  2021-04-27

Details

Name Value
NPI 1700191533
Enumeration Date 2010-08-17
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 7520 MONTGOMERY BLVD NE STE D
ALBUQUERQUE, NM 87109-1521
United States

Phone: 505-883-3722 | Fax: 505-884-1479
View Map External Link
Primary Practice Address 7520 MONTGOMERY BLVD NE STE D
ALBUQUERQUE, NM 87109-1521
United States

Phone: 909-725-4137 | Fax: 505-884-1479
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other STATE LICENSE NM DD3583
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice NM DD3583