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General NPI Number Information
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NPI Number | 1134587736
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Entity Type | Organization
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Legal Business Name | SLOVAN DENTISTRY
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Dates
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Enumeration Date | 02/10/2016
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Last Update Date | 02/10/2016
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Provider Practice Location Address
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Address Line | 4427 S RURAL RD SUITE 2
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City | TEMPE
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State | AZ
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Zip | 85282-7061
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Country | US
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Telephone | 480-897-2274
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Fax |
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Provider Business Mailing Address
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Address Line | 4427 S RURAL RD SUITE 2
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City | TEMPE
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State | AZ
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Zip | 85282-7061
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Country | US
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Telephone | 480-897-2274
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JARED SLOVAN
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Credential | DMD
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Telephone | 843-810-5854
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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 | 8919
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License Number State | AZ
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