Provider Demographics
NPI:1710158456
Name:SLOAN & SLOAN DDS PLLC
Entity Type:Organization
Organization Name:SLOAN & SLOAN DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT SEC
Authorized Official - Prefix:
Authorized Official - First Name:ELDON
Authorized Official - Middle Name:F
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-258-9321
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:BROADWAY
Mailing Address - State:NC
Mailing Address - Zip Code:27505
Mailing Address - Country:US
Mailing Address - Phone:919-258-9321
Mailing Address - Fax:919-258-9741
Practice Address - Street 1:103 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:BROADWAY
Practice Address - State:NC
Practice Address - Zip Code:27505
Practice Address - Country:US
Practice Address - Phone:919-258-9321
Practice Address - Fax:919-258-9741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38311223G0001X
NC84001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty