Provider Demographics
NPI:1033558572
Name:ALLCARE DENTAL GROUP LLC
Entity Type:Organization
Organization Name:ALLCARE DENTAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGE
Authorized Official - Middle Name:
Authorized Official - Last Name:VSEBLUSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-907-7300
Mailing Address - Street 1:3635 GERMANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-4255
Mailing Address - Country:US
Mailing Address - Phone:215-907-7300
Mailing Address - Fax:215-827-5741
Practice Address - Street 1:3635 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-4255
Practice Address - Country:US
Practice Address - Phone:215-907-7300
Practice Address - Fax:215-827-5741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty