Provider Demographics
NPI:1245576677
Name:DR.'S ALTHOUSE, CARROLL AND ALPERIN
Entity Type:Organization
Organization Name:DR.'S ALTHOUSE, CARROLL AND ALPERIN
Other - Org Name:A DIVISION OF ATLANTIC DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-393-2568
Mailing Address - Street 1:3410 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-3205
Mailing Address - Country:US
Mailing Address - Phone:757-393-2568
Mailing Address - Fax:757-399-5069
Practice Address - Street 1:3410 COUNTY ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3205
Practice Address - Country:US
Practice Address - Phone:757-393-2568
Practice Address - Fax:757-399-5069
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTIC DENTAL CARE PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-12
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010056691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty