# AMRISH PATEL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ATLANTIC DENTAL CARE, PLC
- **Other names:** LAKESHORE DENTAL P.C.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790299139
- **Legal business name:** ATLANTIC DENTAL CARE, PLC
- **Authorized official:** AMRISH PATEL DMD (DENTIST)
- **Authorized official phone:** (973) 610-6026

## Contact information

- **Practice address:** 1209 INDEPENDENCE BLVD STE 110, VIRGINIA BEACH, VA 23455-5569
- **Practice address phone:** (757) 490-3111
- **Mailing address:** 1209 INDEPENDENCE BLVD STE 110, VIRGINIA BEACH, VA 23455-5569
- **Mailing address phone:** (757) 490-3111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401414691 | VA | Yes |

## Other

- **Enumeration date:** 11/21/2017
- **Last updated:** 12/07/2017