Provider Demographics
NPI:1851525778
Name:STEPHEN A. FOLSON, DDS MS PC
Entity Type:Organization
Organization Name:STEPHEN A. FOLSON, DDS MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:FOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-977-4279
Mailing Address - Street 1:13260 N 94TH DR
Mailing Address - Street 2:SUITE 410
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4828
Mailing Address - Country:US
Mailing Address - Phone:623-977-4279
Mailing Address - Fax:623-977-8787
Practice Address - Street 1:13260 N 94TH DR
Practice Address - Street 2:SUITE 410
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4828
Practice Address - Country:US
Practice Address - Phone:623-977-4279
Practice Address - Fax:623-977-8787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ2728261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1720282338OtherNPI - TYPE 1 FOR INDIVIDUALS