Provider Demographics
NPI:1376836056
Name:ABSOLUTE DENTAL LLC
Entity Type:Organization
Organization Name:ABSOLUTE DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YEUGENIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-269-7871
Mailing Address - Street 1:5526 BERGENLINE AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-4670
Mailing Address - Country:US
Mailing Address - Phone:201-558-9600
Mailing Address - Fax:201-558-9601
Practice Address - Street 1:5526 BERGENLINE AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-4670
Practice Address - Country:US
Practice Address - Phone:201-558-9600
Practice Address - Fax:201-558-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI0200200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty