Provider Demographics
NPI:1215227657
Name:FORD, HOYT STANLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:HOYT
Middle Name:STANLEY
Last Name:FORD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3612 SHEFFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-1233
Mailing Address - Country:US
Mailing Address - Phone:252-937-4634
Mailing Address - Fax:
Practice Address - Street 1:3612 SHEFFIELD DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27803-1233
Practice Address - Country:US
Practice Address - Phone:252-937-4634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC34421223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics