Healthcare Provider Details

I. General information

NPI: 1225243082
Provider Name (Legal Business Name): MICHAEL C. SLOAN, D.D.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2561 ATLANTIC HIGHWAY
LINCOLNVILLE BEACH ME
04849-0050
US

IV. Provider business mailing address

PO BOX 50
LINCOLNVILLE ME
04849-0050
US

V. Phone/Fax

Practice location:
  • Phone: 207-789-5270
  • Fax: 207-789-5273
Mailing address:
  • Phone: 207-789-5270
  • Fax: 207-789-5273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3352
License Number StateME

VIII. Authorized Official

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