Provider Demographics
NPI:1528026218
Name:SLESNICK, MICHAEL LEE (DDS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LEE
Last Name:SLESNICK
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 1:241 KING ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2335
Mailing Address - Country:US
Mailing Address - Phone:413-585-5425
Mailing Address - Fax:413-585-0472
Practice Address - Street 1:241 KING ST
Practice Address - Street 2:SUITE 120
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2335
Practice Address - Country:US
Practice Address - Phone:413-585-5425
Practice Address - Fax:413-585-0472
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA166421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice