Provider Demographics
NPI:1689430845
Name:ATHENS TINY TEETH PLLC
Entity Type:Organization
Organization Name:ATHENS TINY TEETH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SLAUGHTER
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:225-288-8881
Mailing Address - Street 1:5217 TENNYSON PKWY STE 500
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-4125
Mailing Address - Country:US
Mailing Address - Phone:469-649-1009
Mailing Address - Fax:
Practice Address - Street 1:101 E TYLER ST STE C
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-2547
Practice Address - Country:US
Practice Address - Phone:903-997-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty