Provider Demographics
NPI:1124413166
Name:GLOBAL DENTAL PLUS LLC
Entity Type:Organization
Organization Name:GLOBAL DENTAL PLUS LLC
Other - Org Name:GLOBAL DENTAL PLUS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:OLEG
Authorized Official - Middle Name:
Authorized Official - Last Name:LOSIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-437-1292
Mailing Address - Street 1:9630 BUSTLETON AVE
Mailing Address - Street 2:2 FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-3102
Mailing Address - Country:US
Mailing Address - Phone:215-437-1292
Mailing Address - Fax:
Practice Address - Street 1:9630 BUSTLETON AV 2ND FL
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115
Practice Address - Country:US
Practice Address - Phone:215-437-1292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty