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NPI Code Detail

MEDICARE: TROY KENDALL SLADE DMD

MEDICARE:   TROY KENDALL SLADE  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry5731NV

General Provider Information

NPI Number : 1033368584
Entity Type Code : Individual
Provider Name (Legal Business Name) : TROY KENDALL SLADE DMD
Provider Business Mailing Address
First Line : PO BOX 539
Second Line : STE. 200
City : SANTA YNEZ
State : CA
Zip : 93460-0539
Country : US
Telephone Number : 805-688-7070
Fax Number : 805-686-2060
Provider Business Practice Location Address
First Line : 526 S TONOPAH DR
Second Line : STE. 200
City : LAS VEGAS
State : NV
Zip : 89106-4043
Country : US
Telephone Number : 702-435-5015
Fax Number : 702-366-1483
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2008
Last Update Date : 05/16/2016

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Directions to “ TROY KENDALL SLADE DMD” Practice Location

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