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General NPI Number Information
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NPI Number | 1679238240
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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 | 11/08/2021
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 1300 KEMPSVILLE RD STE 1
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-6199
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Country | US
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Telephone | 757-467-8181
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Fax | 800-879-3455
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Provider Business Mailing Address
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Address Line | 1300 KEMPSVILLE RD STE 1
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-6199
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Country | US
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Telephone | 757-467-8181
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Fax | 800-879-3455
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Authorized Official
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Title or Position | OWNER
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Name | ESTELITO MORENO SANTOS
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Credential | DDS
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Telephone | 757-944-1793
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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