Provider Demographics
NPI:1427311612
Name:FORD, KARA DESPER (DMD)
Entity type:Individual
Prefix:DR
First Name:KARA
Middle Name:DESPER
Last Name:FORD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 BROOKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7035
Mailing Address - Country:US
Mailing Address - Phone:270-779-0782
Mailing Address - Fax:
Practice Address - Street 1:113 CIRCLE WAY ST
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5233
Practice Address - Country:US
Practice Address - Phone:979-297-5151
Practice Address - Fax:979-297-2851
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9217122300000X
TX29850122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist