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Organization
GFD CC LLC
Active
Organization
GFD CC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEOFFREY LOUIS GLOGAS DDS (MEMBER/PRESIDENT)
(260) 450-4579
Entity
Organization
Contact information
Practice address
506 N LINE ST, COLUMBIA CITY, IN 46725-1230
(260) 248-4242
Mailing address
8427 SPRING FOREST DR, FORT WAYNE, IN 46804-6496
(260) 436-4377
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
12010658A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200838370A
—
IN
Enumeration date
10/26/2014
Last updated
10/26/2014
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