Provider Demographics
NPI:1881993897
Name:JOHN C. SLAUGHTER,D.D.S
Entity type:Organization
Organization Name:JOHN C. SLAUGHTER,D.D.S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SLAUGHTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:207-338-3669
Mailing Address - Street 1:19 FAHEY ST
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6028
Mailing Address - Country:US
Mailing Address - Phone:207-338-3669
Mailing Address - Fax:207-338-3681
Practice Address - Street 1:19 FAHEY ST
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6028
Practice Address - Country:US
Practice Address - Phone:207-338-3669
Practice Address - Fax:207-338-3681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2554122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty