| A Division Of Atlantic Dental Care | |
|
1301 Bridgeport Way Ste 109 Suffolk VA 23435-1960 | |
| (757) 484-1444 | |
| (757) 484-3712 |
| Full Name | A Division Of Atlantic Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 1301 Bridgeport Way Ste 109, Suffolk, Virginia |
| Authorized Official Name and Position | Brian Gene Briesemeister (DENTIST) |
| Authorized Official Contact | 7574841444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Division Of Atlantic Dental Care 1301 Bridgeport Way Ste 109 Suffolk VA 23435-1960 Ph: (757) 484-1444 | A Division Of Atlantic Dental Care 1301 Bridgeport Way Ste 109 Suffolk VA 23435-1960 Ph: (757) 484-1444 |
| NPI Number | 1871158691 |
|---|---|
| Provider Enumeration Date | 05/07/2019 |
| Last Update Date | 03/30/2023 |
| Medicare PECOS PAC ID | 0143655662 |
|---|---|
| Medicare Enrollment ID | O20200110000802 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871158691 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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