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General NPI Number Information
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NPI Number | 1043401458
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Entity Type | Individual
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Provider Name | MICAL CLAYTON SLATER D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 08/15/2007
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Provider Practice Location Address
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Address Line | 2929 N UNIVERSITY DR STE 203
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-1424
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Country | US
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Telephone | 954-288-2948
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Fax |
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Provider Business Mailing Address
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Address Line | 6768 SW 39TH CT
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City | DAVIE
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State | FL
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Zip | 33314-3202
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Country | US
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Telephone | 954-288-2948
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DN18120
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License Number State | FL
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