Provider Demographics
NPI:1740460674
Name:DRS GELMAN DENTAL GROUP INC
Entity type:Organization
Organization Name:DRS GELMAN DENTAL GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-345-2777
Mailing Address - Street 1:5554 RESEDA BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2200
Mailing Address - Country:US
Mailing Address - Phone:818-345-2777
Mailing Address - Fax:818-345-2778
Practice Address - Street 1:5554 RESEDA BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2200
Practice Address - Country:US
Practice Address - Phone:818-345-2777
Practice Address - Fax:818-345-2778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA495261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty