Southfield Dental Pllc

LBN: Southfield Dental Pllc
Southfield Dental Pllc is an health care organization with primary practice located at 17600 W 12 Mile Rd Suite 3, Southfield MI 48076-1910. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Southfield Dental Pllc can be contacted via phone (248) 569-6722, or through Fortson, Raymond A via phone (248) 569-6722.

Contact Information

Primary practice address
17600 W 12 Mile Rd Suite 3 Southfield MI 48076-1910
Phone: (248) 569-6722
Fax: (248) 569-7409
Website:
Map and Directions
Authorized official contact:
Name: Fortson, Raymond A Doctor of Dental Surgery (DDS)
Phone: (248) 569-6722

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 2901014077 Michigan

Profile Details

NPI number 1104067644
LBN Legal business name Southfield Dental Pllc
DBA Doing business as
Authorized official Fortson, Raymond A Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 12th, 2009
Last updated Mar 12th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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