Organization
GRAHAM DENTAL
Active
Parent organization
ATLANTIC DENTAL CARE, PLC
Other names
a division of Atlantic Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
ATLANTIC DENTAL CARE, PLC
Authorized official
DR. DAVID BRUCE GRAHAM D.D.S. (DENTIST)
(757) 547-7070
Entity
Organization
Contact information
Practice address
524 ALBEMARLE DR, CHESAPEAKE, VA 23322-5500
(757) 547-3869
Mailing address
524 ALBEMARLE DR, CHESAPEAKE, VA 23322-5500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401005774
VA
122300000X
Dentist
0401414963
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007818807
—
VA
Enumeration date
11/04/2015
Last updated
11/04/2015
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