Provider Demographics
NPI:1013447895
Name:SLETTO, JEFFREY E JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:E
Last Name:SLETTO
Suffix:JR
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 1:145 MAPLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65742-9501
Mailing Address - Country:US
Mailing Address - Phone:816-377-5644
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:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170192021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice