Provider Demographics
NPI:1770657322
Name:SLUDER, TROY BUNYON III (DDS)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:BUNYON
Last Name:SLUDER
Suffix:III
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:PO BOX 490
Mailing Address - Street 2:503 CYPRESS LANE, UNIT C
Mailing Address - City:MANTEO
Mailing Address - State:NC
Mailing Address - Zip Code:27954-0490
Mailing Address - Country:US
Mailing Address - Phone:252-475-9841
Mailing Address - Fax:252-475-9843
Practice Address - Street 1:503 CYPRESS LANE, UNIT C
Practice Address - Street 2:
Practice Address - City:MANTEO
Practice Address - State:NC
Practice Address - Zip Code:27954
Practice Address - Country:US
Practice Address - Phone:252-475-9841
Practice Address - Fax:252-475-9843
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5847122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist