Provider Demographics
NPI:1932116548
Name:SLONE, ANGLEA (DMD)
Entity Type:Individual
Prefix:
First Name:ANGLEA
Middle Name:
Last Name:SLONE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ANGLEA
Other - Middle Name:
Other - Last Name:SLONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:9590 MEDLOCK BRIDGE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-4443
Mailing Address - Country:US
Mailing Address - Phone:770-495-9004
Mailing Address - Fax:
Practice Address - Street 1:9590 MEDLOCK BR RD
Practice Address - Street 2:STE D
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097
Practice Address - Country:US
Practice Address - Phone:770-495-9004
Practice Address - Fax:770-495-1422
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011450122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist