# GLOSMAN DENTAL GROUP, LTD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GLOSMAN DENTAL GROUP, LTD
- **Other names:** Dentalville
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164603502
- **Legal business name:** GLOSMAN DENTAL GROUP, LTD
- **Authorized official:** MONIQUE R GLOSMAN DDS (CHIEF OF STAFF)
- **Authorized official phone:** (310) 480-2307

## Contact information

- **Practice address:** 5060 S FORT APACHE RD, \#160, LAS VEGAS, NV 89148-1731
- **Practice address phone:** (702) 851-8200
- **Practice address fax:** (702) 851-8201
- **Mailing address:** 833 W WHITTIER BLVD, MONTEBELLO, CA 90640-4735
- **Mailing address phone:** (323) 266-1000
- **Mailing address fax:** (323) 372-1662

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3580 | NV | Yes |

## Other

- **Enumeration date:** 11/14/2007
- **Last updated:** 06/07/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100512440 | — | NV |