Provider Demographics
NPI:1346519550
Name:MOHAMED AND FOULKES DDS PA IV
Entity Type:Organization
Organization Name:MOHAMED AND FOULKES DDS PA IV
Other - Org Name:GREENVILLE SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:ERSKINE
Authorized Official - Last Name:FOULKES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-699-9947
Mailing Address - Street 1:1805 W ARLINGTON BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5700
Mailing Address - Country:US
Mailing Address - Phone:252-321-8543
Mailing Address - Fax:
Practice Address - Street 1:1805 W ARLINGTON BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5700
Practice Address - Country:US
Practice Address - Phone:252-321-8543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC76031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty