Southfield Dental Pllc is a Dental Clinic in Southfield, Michigan. It is located at 17600 W 12 Mile Rd, Suite 3, Southfield, MI and its contact number is 248-569-6722. The authorized person for Southfield Dental Pllc is Dr. Raymond A Fortson Jr.
who is Member of the clinic and their contact number is 248-569-6722. The primary license number for Southfield Dental Pllc is 2901014077 (Dentist) in Michigan.
Southfield Dental Pllc Clinic have dental surgeons who are specialized in dentistry, diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.
Complete Clinic Profile:
Southfield Dental Pllc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Southfield Dental Pllc |
| Specialization: | Dentistry |
| Clinic Address: | 17600 W 12 Mile Rd, Suite 3, Southfield,
Michigan, 48076-1910 |
| Phone: | 248-569-6722 |
| Fax: | 248-569-7409 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Raymond A Fortson Jr. |
| Position: | Member |
| Contact Number: | 248-569-6722 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Southfield Dental Pllc clinic are as mentioned below.
| NPI Number: | 1104067644 |
| NPI Enumeration Date: | 12 Mar, 2009 |
| NPI Last Update On: | 12 Mar, 2009 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Southfield Dental Pllc are as mentioned below.
| Specialization | License Number | State | Status | |
| Dentist | 2901014077 | Michigan | Primary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Southfield Dental Pllc
17600 W 12 Mile Rd, Suite 3
Southfield, Michigan |
| Zip: | 48076-1910 |
| Phone Number: | 248-569-6722 |
| Fax Number: | 248-569-7409 |
Patients can reach Southfield Dental Pllc at
17600 W 12 Mile Rd, Suite 3, Southfield, Michigan or can
call to book an appointment on 248-569-6722.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.