Healthcare Provider Details

I. General information

NPI: 1003250531
Provider Name (Legal Business Name): JAMES M. SLAMAN, D.D.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2013
Last Update Date: 04/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8010 PALOMAS AVE NE SUITE B
ALBUQUERQUE NM
87109-5201
US

IV. Provider business mailing address

8010 PALOMAS AVE NE SUITE B
ALBUQUERQUE NM
87109-5201
US

V. Phone/Fax

Practice location:
  • Phone: 505-881-7586
  • Fax: 505-880-1769
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDD2953
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDD1744
License Number StateNM

VIII. Authorized Official

Name: DR. JAMES M SLAMAN
Title or Position: OWNER
Credential: D.D.S.
Phone: 505-881-7586