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Search › Michigan › Oral and Maxillofacial Surgery (Dentist)

Cory Fortson

NPI 1306258280 · on the registry since 2014 · sole proprietor

Practice

Address
17600 W 12 Mile Rd Ste 3
Southfield, MI 48076
Phone
(248) 569-6722
Fax
(248) 569-7409
Organisation at this address
Eagan Orthodontics Pc
Southfield Dental Pllc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Registry record

Primary taxonomy
Oral and Maxillofacial Surgery (Dentist)
1223S0112X
Also registered as
Dentist
Licence states on file
MI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-05-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan