Provider Demographics
NPI:1740490945
Name:SLOTTEN, JEFFREY REID (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:REID
Last Name:SLOTTEN
Suffix:
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 1:5421 NW 69TH LN
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-7016
Mailing Address - Country:US
Mailing Address - Phone:352-338-0721
Mailing Address - Fax:386-328-0079
Practice Address - Street 1:205 ZEAGLER DR
Practice Address - Street 2:SUITE 502
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3888
Practice Address - Country:US
Practice Address - Phone:386-328-1500
Practice Address - Fax:386-328-0079
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN101631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice