Healthcare Provider Details

I. General information

NPI: 1710044573
Provider Name (Legal Business Name): FRANK SCOTT SLEDER SR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 CUMING ST
OMAHA NE
68102-4325
US

IV. Provider business mailing address

1208 N 161ST CIR
OMAHA NE
68118-2440
US

V. Phone/Fax

Practice location:
  • Phone: 402-280-5184
  • Fax:
Mailing address:
  • Phone: 402-498-5602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number5257
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: