CORY FORTSON

SOUTHFIELD, MI
NPI1306258280
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: MI  2901021215)
Additional Taxonomies122300000X Dentist
(Licence: MI  2901021215)
Enumeration Date2014-05-27
Last Update Date2024-05-08
Business Address
Dr. CORY FORTSON
17600 W 12 MILE RD STE 3
SOUTHFIELD, MI 48076-1910
Phone number: 248-569-6722
Mailing Address
Dr. CORY FORTSON
17600 W 12 MILE RD STE 3
SOUTHFIELD, MI 48076-1910
Phone number: 248-569-6722