| NPI | 1407239213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FOLCK President 757-428-7440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401003722) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-06-30 |