Individual
EMILY ROSE FORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4855 W CENTRE AVE STE A, PORTAGE, MI 49024-4686
(269) 375-0800
Mailing address
8370 SHIRLEY CT APT 341, PORTAGE, MI 49024-4892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901602690
MI
Other
Enumeration date
07/02/2025
Last updated
07/02/2025
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