Healthcare Provider Details

I. General information

NPI: 1295930303
Provider Name (Legal Business Name): VICTOR CLARKE FOLTZ III D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

969 EISENHOWER BLVD STE C
JOHNSTOWN PA
15904-3326
US

IV. Provider business mailing address

969 EISENHOWER BLVD STE C
JOHNSTOWN PA
15904-3326
US

V. Phone/Fax

Practice location:
  • Phone: 814-410-6015
  • Fax:
Mailing address:
  • Phone: 814-410-6015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS028630L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License NumberDS028630L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: