Provider Demographics
NPI:1669147617
Name:SLAVIK, KRISTINA (DDS)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:SLAVIK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8648 WOODBURY ACRE CT
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37341-1800
Mailing Address - Country:US
Mailing Address - Phone:423-505-9580
Mailing Address - Fax:
Practice Address - Street 1:2122 GUNBARREL RD UNIT 2
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-5198
Practice Address - Country:US
Practice Address - Phone:865-697-2439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC123871223G0001X
TN125351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice