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General NPI Number Information
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NPI Number | 1255174108
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Entity Type | Individual
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Provider Name | MADELINE DEBRA SLATER DDS
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Gender | Female
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Dates
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Enumeration Date | 06/18/2024
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 1557 W 84TH AVE # 1
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City | FEDERAL HEIGHTS
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State | CO
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Zip | 80260-4780
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Country | US
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Telephone | 303-426-4860
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Fax |
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Provider Business Mailing Address
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Address Line | 40 GRYN CT
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City | IOWA CITY
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State | IA
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Zip | 52246-4440
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Country | US
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Telephone | 641-251-4678
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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 | DEN.00206044
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License Number State | CO
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