Provider Demographics
NPI:1699888073
Name:FOLBE, ELLEN B (DDS)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:B
Last Name:FOLBE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12500 E 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-3518
Mailing Address - Country:US
Mailing Address - Phone:586-573-6677
Mailing Address - Fax:586-573-6680
Practice Address - Street 1:12500 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3518
Practice Address - Country:US
Practice Address - Phone:586-573-6677
Practice Address - Fax:586-573-6680
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI163411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice