Individual
DR. PAUL THOMAS FOULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
155 N 3RD ST, CONNEAUT LAKE, PA 16316
(814) 382-5100
(814) 382-5100
Mailing address
PO BOX 492, 155 N 3RD ST, CONNEAUT LAKE, PA 16316-0492
(814) 382-5100
(814) 382-5100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS027873L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012612260001
—
PA
01
—
10298
UPMC FOR U
PA
01
—
66691
MEDPLUS
PA
Enumeration date
11/21/2005
Last updated
07/08/2007
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