Provider Demographics
NPI:1215094826
Name:FOLTZ, JEFFREY D (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:D
Last Name:FOLTZ
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 1:13135 MORNINGPARK CIR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-7332
Mailing Address - Country:US
Mailing Address - Phone:678-232-1607
Mailing Address - Fax:
Practice Address - Street 1:13135 MORNINGPARK CIR
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-7332
Practice Address - Country:US
Practice Address - Phone:678-232-1607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10446122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist