Provider Demographics
NPI:1366481673
Name:KORPICS, LOUIS J JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:J
Last Name:KORPICS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-1526
Mailing Address - Country:US
Mailing Address - Phone:804-798-2776
Mailing Address - Fax:804-798-3110
Practice Address - Street 1:130 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-1526
Practice Address - Country:US
Practice Address - Phone:804-798-2776
Practice Address - Fax:804-798-3110
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010076531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice