MEDICARE: GLOBAL DENTAL MANAGEMENT INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	4289	NV

General Provider Information

NPI Number	:	1447459235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOBAL DENTAL MANAGEMENT INC.

Provider Business Mailing Address
First Line	:	3774 E DESERT INN RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3339
Country	:	US
Telephone Number	:	702-257-2872
Fax Number	:	702-257-2880

Provider Business Practice Location Address
First Line	:	3774 E DESERT INN RD
Second Line	:	SUITE 315
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3339
Country	:	US
Telephone Number	:	702-257-2872
Fax Number	:	702-257-2880

Authorized Official
Title or Position	:	DENTIST
Name	:	GHASSAN H. KHALAF
Credential	:	DDS
Telephone Number	:	702-257-2872

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	01/09/2008

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