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General NPI Number Information
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NPI Number | 1669987962
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Entity Type | Organization
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Legal Business Name | ATLANTIC DENTAL CARE PLC
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 700 INDEPENDENCE CIR STE 1A
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-6405
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Country | US
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Telephone | 757-490-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 1209 INDEPENDENCE BLVD STE 110
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-5569
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Country | US
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Telephone | 757-490-3111
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | AMRISH PATEL
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Credential | DMD
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Telephone | 973-610-6026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401414691
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License Number State | VA
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