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Organization

FORTSON DENTISTRY LATHRUP NORTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMIE SOLI (REGIONAL MANAGER)
(248) 398-5400
Entity
Organization

Contact information

Practice address
27445 SOUTHFIELD RD, LATHRUP VILLAGE, MI 48076-3411
(248) 423-9000
(248) 569-7409
Mailing address
27445 SOUTHFIELD RD, LATHRUP VILLAGE, MI 48076-3411
(248) 423-9000

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
02/22/2018
Last updated
02/22/2018
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