Provider Demographics
NPI:1407052517
Name:SLOANE, KENNETH B (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:B
Last Name:SLOANE
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 1:500 PIERMONT RD
Mailing Address - Street 2:SUITE201
Mailing Address - City:CLOSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07624-2845
Mailing Address - Country:US
Mailing Address - Phone:201-768-4242
Mailing Address - Fax:291-768-5144
Practice Address - Street 1:500 PIERMONT RD
Practice Address - Street 2:SUITE201
Practice Address - City:CLOSTER
Practice Address - State:NJ
Practice Address - Zip Code:07624-2845
Practice Address - Country:US
Practice Address - Phone:201-768-4242
Practice Address - Fax:291-768-5144
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01951900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist