Provider Demographics
NPI:1679036016
Name:SLOAN PEAY FAMILY DENTISTRY
Entity Type:Organization
Organization Name:SLOAN PEAY FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:602-740-5418
Mailing Address - Street 1:4519 N 40TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3603
Mailing Address - Country:US
Mailing Address - Phone:602-955-4890
Mailing Address - Fax:
Practice Address - Street 1:4519 N 40TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3603
Practice Address - Country:US
Practice Address - Phone:602-955-4890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental