Provider Demographics
NPI:1477098960
Name:THE FOLECK CENTER, LTD.
Entity Type:Organization
Organization Name:THE FOLECK CENTER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MERKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-965-7696
Mailing Address - Street 1:1436 S INDEPENDENCE BLVD
Mailing Address - Street 2:100
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5251
Mailing Address - Country:US
Mailing Address - Phone:757-965-7696
Mailing Address - Fax:757-965-7690
Practice Address - Street 1:1436 S INDEPENDENCE BLVD
Practice Address - Street 2:100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5251
Practice Address - Country:US
Practice Address - Phone:757-965-7696
Practice Address - Fax:757-965-7690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-20
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010088731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty