Provider Demographics
NPI:1073533071
Name:SLADEK, LAWRENCE ALEXANDER (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ALEXANDER
Last Name:SLADEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23308
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-0276
Mailing Address - Country:US
Mailing Address - Phone:704-545-3243
Mailing Address - Fax:704-545-9233
Practice Address - Street 1:7322 MATTHEWS MINT HILL RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-0276
Practice Address - Country:US
Practice Address - Phone:704-545-3243
Practice Address - Fax:704-545-9233
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC41161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice