Provider Demographics
NPI:1811333552
Name:NORMAN D. SLOVIS
Entity type:Organization
Organization Name:NORMAN D. SLOVIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:SLOVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-721-3567
Mailing Address - Street 1:1438 DEFENSE HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-2023
Mailing Address - Country:US
Mailing Address - Phone:410-721-3567
Mailing Address - Fax:
Practice Address - Street 1:1438 DEFENSE HWY STE 101
Practice Address - Street 2:
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-2023
Practice Address - Country:US
Practice Address - Phone:410-721-3567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4846122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty