Provider Demographics
NPI:1255873261
Name:LOUIS J KORPICS JR., DDS
Entity type:Organization
Organization Name:LOUIS J KORPICS JR., DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-798-2776
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
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTERAL VIRGINIA DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty