Fortson Dental, P.c.
NPI #1992197172 in Lathrup Village, Michigan
Provider Information
- NPI Number
- 1992197172
- Entity Type
- Organization
- Organization Name
- Fortson Dental, P.c.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 25, 2015
- Last Updated
- Feb 25, 2015
Practice Location
- Address
- 27445 SOUTHFIELD RD
- City
- Lathrup Village
- State
- Michigan
- ZIP Code
- 48076-3411
- Phone
- (248) 352-1110
Authorized Official
- Name
- DR. RAYMOND FORTSON JR., DDS
- Title
- PRESIDENT
- Phone
- (248) 569-6722
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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