| NPI | 1710223839 |
|---|---|
| Doing Business As | A DIVISION OF ATLANTIC DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | CARRIE CLARKSON Dentist 757-420-1507 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 10798) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 6412) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2012-12-18 |