DR. Cory Fortson
NPI #1306258280 in Southfield, Michigan
Provider Information
- NPI Number
- 1306258280
- Entity Type
- Individual
- Name
- DR. Cory Fortson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- May 27, 2014
- Last Updated
- May 8, 2024
Practice Location
- Address
- 17600 W 12 MILE RD STE 3
- City
- Southfield
- State
- Michigan
- ZIP Code
- 48076-1910
- Phone
- (248) 569-6722
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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