Provider Demographics
NPI:1518120807
Name:SLONKOSKY, PHILIP WILLIAM (DMD,MS)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:WILLIAM
Last Name:SLONKOSKY
Suffix:
Gender:M
Credentials:DMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:MINSTER
Mailing Address - State:OH
Mailing Address - Zip Code:45865-0102
Mailing Address - Country:US
Mailing Address - Phone:419-628-3380
Mailing Address - Fax:419-628-3670
Practice Address - Street 1:4215 STATE ROUTE 66
Practice Address - Street 2:
Practice Address - City:MINSTER
Practice Address - State:OH
Practice Address - Zip Code:45865-0102
Practice Address - Country:US
Practice Address - Phone:419-628-3380
Practice Address - Fax:419-628-3670
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY84831223P0221X
OH30-0229741223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry