Fortson, Cory

Fortson, Cory is an sole proprietor health care provider with primary practice located at 17600 W 12 Mile Rd Ste 3 , Southfield MI 48076-1910. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Fortson, Cory can be contacted via phone (248) 569-6722.

Contact Information

Primary practice address
17600 W 12 Mile Rd Ste 3 Southfield MI 48076-1910
Phone: (248) 569-6722
Fax: (248) 569-7409
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 2901021215 Michigan
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 2901021215 Michigan

Profile Details

NPI number 1306258280
LBN Legal business name Fortson, Cory
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 27th, 2014
Last updated May 8th, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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