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General NPI Number Information
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NPI Number | 1730652397
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Entity Type | Organization
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Legal Business Name | SLETTO DENTAL LLC
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 3540 S NATIONAL AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65807-7309
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Country | US
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Telephone | 417-886-9094
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Fax |
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Provider Business Mailing Address
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Address Line | 3540 S NATIONAL AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65807-7309
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Country | US
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Telephone | 417-886-9094
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JEFFREY E SLETTO JR.
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Credential | DDS
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Telephone | 417-886-9094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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