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General NPI Number Information
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NPI Number | 1033556162
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Entity Type | Organization
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Legal Business Name | TROY B SLUDER III DDS PLLC
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 503 CYPRESS LANE SUITE C
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City | MANTEO
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State | NC
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Zip | 27954
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Country | US
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Telephone | 252-475-9841
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Fax | 252-475-9843
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Provider Business Mailing Address
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Address Line | PO BOX 490
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City | MANTEO
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State | NC
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Zip | 27954-0490
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Country | US
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Telephone | 252-475-9841
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Fax | 252-475-9843
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Authorized Official
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Title or Position | DENTIST
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Name | DR. TROY B SLUDER III
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Credential | DDS
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Telephone | 252-475-9841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5847
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License Number State | NC
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