Susan Cope Fortenberry D.M.D.

NPI 1083936132 - Dentist - 1223P0221X

NPI Details
NPI 1083936132
Gender Female
Enumeration Date 02/17/2010
Last Updated 02/17/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
5315 HIGHWAY 18 W
JACKSON MS, 39209-9421, US
Phone (601) 922-0066
Fax (601) 922-0077
Business Location
5315 HIGHWAY 18 W
JACKSON MS, 39209-9421, US
Phone (601) 922-0066
Fax (601) 922-0077
Toxanomy
Taxonomy Code 1223P0221X
License State Mississippi
License Number 3429-07
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According to our database, Dr. Susan Cope Fortenberry D.M.D. NPI is 1083936132, taxonomy code is 1223P0221X and license number is 3429-07, license state is located at Mississippi. Susan Cope Fortenberry D.M.D. physically located at 5315 Highway 18 W, Jackson MS, 39209-9421. NPI Number Susan Cope Fortenberry D.M.D. has the Individual type.

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1083936132 NPI number is provided on an as is basis without warranty of any kind. 1083936132 is maintained by the National Plan & Provider Enumeration System. The contents of Susan Cope Fortenberry D.M.D. are for informational purposes only.