Provider Demographics
NPI:1972670206
Name:SLETTEN, DANIEL WAYNE (DDS, MS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:WAYNE
Last Name:SLETTEN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3344 BARONS WAY
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-4799
Mailing Address - Country:US
Mailing Address - Phone:651-430-3839
Mailing Address - Fax:
Practice Address - Street 1:6303 OSGOOD AVE N
Practice Address - Street 2:SUITE 205
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6101
Practice Address - Country:US
Practice Address - Phone:651-439-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND115611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics