Provider Demographics
NPI:1205027976
Name:DANIEL M. SLAVSKY, D.M.D., LLC
Entity Type:Organization
Organization Name:DANIEL M. SLAVSKY, D.M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SLAVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-339-7171
Mailing Address - Street 1:98 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-2253
Mailing Address - Country:US
Mailing Address - Phone:508-339-7171
Mailing Address - Fax:508-339-7178
Practice Address - Street 1:98 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-2253
Practice Address - Country:US
Practice Address - Phone:508-339-7171
Practice Address - Fax:508-339-7178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20945122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty