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General NPI Number Information
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NPI Number | 1043920895
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Entity Type | Individual
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Provider Name | NICOLE SLAVOSKI DMD
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Gender | Female
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Dates
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Enumeration Date | 12/02/2022
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 92 NEALY BLVD
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City | HAMPTON
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State | VA
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Zip | 23665-2022
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Country | US
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Telephone | 757-215-6176
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Fax |
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Provider Business Mailing Address
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Address Line | 4636 CURTISS DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-4320
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 00205135
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License Number State | CO
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