Provider Demographics
NPI:1508261827
Name:DR. SCOTT J. GOLRICH
Entity Type:Organization
Organization Name:DR. SCOTT J. GOLRICH
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:SCOTT
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOLRICH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:757-898-4646
Mailing Address - Street 1:4030 GEORGE WASHINGTON MEM HWY
Mailing Address - Street 2:STE A
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-2619
Mailing Address - Country:US
Mailing Address - Phone:757-898-4646
Mailing Address - Fax:757-898-8264
Practice Address - Street 1:4030 GEORGE WASHINGTON MEM HWY
Practice Address - Street 2:STE A
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-2619
Practice Address - Country:US
Practice Address - Phone:757-898-4646
Practice Address - Fax:757-898-8264
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTIC DENTAL CARE, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401008751122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty