Provider Demographics
NPI:1649398561
Name:SLOTKIN, LEE ALAN
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:ALAN
Last Name:SLOTKIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 STATE HIGHWAY 27
Mailing Address - Street 2:SUITE 3800
Mailing Address - City:SOMERST
Mailing Address - State:NJ
Mailing Address - Zip Code:08873
Mailing Address - Country:US
Mailing Address - Phone:732-247-5959
Mailing Address - Fax:732-247-0334
Practice Address - Street 1:1553 STATE HIGHWAY 27
Practice Address - Street 2:SUITE 3800
Practice Address - City:SOMERST
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:732-247-5959
Practice Address - Fax:732-247-0334
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI118911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice