Provider Demographics
NPI:1629011390
Name:FOLECK, ADAM S (DMD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:S
Last Name:FOLECK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 COLLEGE PL
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1272
Mailing Address - Country:US
Mailing Address - Phone:757-623-0283
Mailing Address - Fax:757-623-0339
Practice Address - Street 1:201 COLLEGE PL STE 111
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1272
Practice Address - Country:US
Practice Address - Phone:757-623-0283
Practice Address - Fax:757-623-0339
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010088731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice