Provider Demographics
NPI:1902823651
Name:SLODOV, ANDREW JAY (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JAY
Last Name:SLODOV
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Gender:M
Credentials:DDS, MSD
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Mailing Address - Street 1:8848 COMMONS BLVD
Mailing Address - Street 2:SUITE #201
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-6807
Mailing Address - Country:US
Mailing Address - Phone:330-963-5905
Mailing Address - Fax:330-963-9926
Practice Address - Street 1:8848 COMMONS BLVD
Practice Address - Street 2:SUITE #201
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-6807
Practice Address - Country:US
Practice Address - Phone:330-963-5905
Practice Address - Fax:330-963-9926
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH300186551223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics