Provider Demographics
NPI:1871642421
Name:GLOBAL DENTAL CENTER INC.
Entity Type:Organization
Organization Name:GLOBAL DENTAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACINTO
Authorized Official - Middle Name:W
Authorized Official - Last Name:BEARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-472-2220
Mailing Address - Street 1:4337 CLEVELAND AVE STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-5504
Mailing Address - Country:US
Mailing Address - Phone:614-472-2220
Mailing Address - Fax:
Practice Address - Street 1:4337 CLEVELAND AVE STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-5504
Practice Address - Country:US
Practice Address - Phone:614-472-2220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-95881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2497267Medicaid