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General NPI Number Information
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NPI Number | 1083454797
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Entity Type | Organization
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Legal Business Name | THE FOLECK CENTER, LTD.
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 3824 KECOUGHTAN RD
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City | HAMPTON
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State | VA
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Zip | 23669-4402
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Country | US
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Telephone | 757-727-7726
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Fax | 757-644-3000
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Provider Business Mailing Address
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Address Line | 1436 S INDEPENDENCE BLVD STE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-5295
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Country | US
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Telephone | 757-916-4602
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Fax | 757-644-3000
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Authorized Official
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Title or Position | OWNER
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Name | ADAM FOLECK
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Credential | DMD
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Telephone | 757-965-7696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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