Provider Demographics
NPI:1083454797
Name:THE FOLECK CENTER, LTD.
Entity type:Organization
Organization Name:THE FOLECK CENTER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLECK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:757-965-7696
Mailing Address - Street 1:1436 S INDEPENDENCE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5295
Mailing Address - Country:US
Mailing Address - Phone:757-916-4602
Mailing Address - Fax:757-644-3000
Practice Address - Street 1:3824 KECOUGHTAN RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-4402
Practice Address - Country:US
Practice Address - Phone:757-727-7726
Practice Address - Fax:757-644-3000
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE FOLECK CENTER, LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty