MEDICARE: MICHAEL C. SLOAN, D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3352	ME

General Provider Information

NPI Number	:	1225243082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL C. SLOAN, D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 50
Second Line	:
City	:	LINCOLNVILLE
State	:	ME
Zip	:	04849-0050
Country	:	US
Telephone Number	:	207-789-5270
Fax Number	:	207-789-5273

Provider Business Practice Location Address
First Line	:	2561 ATLANTIC HIGHWAY
Second Line	:
City	:	LINCOLNVILLE BEACH
State	:	ME
Zip	:	04849-0050
Country	:	US
Telephone Number	:	207-789-5270
Fax Number	:	207-789-5273

Authorized Official
Title or Position	:	OWNER & DENTIST
Name	:	DR. MICHAEL C SLOAN
Credential	:	D.D.S.
Telephone Number	:	207-789-5270

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	08/22/2020

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