DR. Susan Cope Fortenberry, D.M.D.
NPI #1083936132 in Jackson, Mississippi
Provider Information
- NPI Number
- 1083936132
- Entity Type
- Individual
- Name
- DR. Susan Cope Fortenberry, D.M.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - Pediatric Dentistry
- Credential
- D.M.D.
- Enumeration Date
- Feb 17, 2010
- Last Updated
- Feb 17, 2010
Practice Location
- Address
- 5315 HIGHWAY 18 W
- City
- Jackson
- State
- Mississippi
- ZIP Code
- 39209-9421
- Phone
- (601) 922-0066
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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