Provider Demographics
NPI:1679654610
Name:SLATE, RICHARD LOWELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LOWELL
Last Name:SLATE
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 1:6140 PARKLAND BLVD STE 100
Mailing Address - Street 2:AMERICAN DENTAL CENTERS
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124
Mailing Address - Country:US
Mailing Address - Phone:440-446-1555
Mailing Address - Fax:440-446-1990
Practice Address - Street 1:91 CHAPEL HILL MALL 2000 BRITTAIN RD
Practice Address - Street 2:AMERICAN DENTAL CENTERS
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310
Practice Address - Country:US
Practice Address - Phone:330-630-9222
Practice Address - Fax:330-630-2339
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH139821223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics