Provider Demographics
NPI:1952771040
Name:FLOSS & GLOSS DENTAL GROUP LLC
Entity Type:Organization
Organization Name:FLOSS & GLOSS DENTAL GROUP LLC
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DONMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-394-1416
Mailing Address - Street 1:3200 FRANKFORD AVE # 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-3217
Mailing Address - Country:US
Mailing Address - Phone:215-739-5600
Mailing Address - Fax:215-291-0654
Practice Address - Street 1:8462 JACKSON ST FL 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-2428
Practice Address - Country:US
Practice Address - Phone:267-394-1416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty