| NPI | 1770988644 |
|---|---|
| Doing Business As | A DIVISION OF ATLANTIC DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | JEROME FRANCIS FORETICH Dentist 757-877-0775 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401007967) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2014-11-04 |