Provider Demographics
NPI:1730652397
Name:SLETTO DENTAL LLC
Entity Type:Organization
Organization Name:SLETTO DENTAL LLC
Other - Org Name:ARTISAN DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SLETTO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:417-886-9094
Mailing Address - Street 1:3540 S NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-7309
Mailing Address - Country:US
Mailing Address - Phone:417-886-9094
Mailing Address - Fax:
Practice Address - Street 1:3540 S NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-7309
Practice Address - Country:US
Practice Address - Phone:417-886-9094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-07
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty