Provider Demographics
NPI:1720282338
Name:FOLSON, STEPHEN ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ALAN
Last Name:FOLSON
Suffix:
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 1:13260 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
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27281223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics