Provider Demographics
NPI:1235476557
Name:ELDON F SLOAN III DDS PLLC
Entity Type:Organization
Organization Name:ELDON F SLOAN III DDS PLLC
Other - Org Name:SLOAN AND SLOAN FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELDON
Authorized Official - Middle Name:F
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-258-9321
Mailing Address - Street 1:PO BOX 577
Mailing Address - Street 2:
Mailing Address - City:BROADWAY
Mailing Address - State:NC
Mailing Address - Zip Code:27505-0577
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:103 CHURCH ST
Practice Address - Street 2:
Practice Address - City:BROADWAY
Practice Address - State:NC
Practice Address - Zip Code:27505-9394
Practice Address - Country:US
Practice Address - Phone:919-258-6083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty