MEDICARE: DR. SAUL I SLOAN D.D.S.

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
1	1223G0001X	General Practice Dentistry	5166	CT

General Provider Information

NPI Number	:	1184706962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAUL I SLOAN D.D.S.

Provider Business Mailing Address
First Line	:	51 TIMBER LN
Second Line	:
City	:	FAIRFIELD
State	:	CT
Zip	:	06824-2265
Country	:	US
Telephone Number	:	203-255-0305
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 MONROE TPKE
Second Line	:
City	:	MONROE
State	:	CT
Zip	:	06468-2343
Country	:	US
Telephone Number	:	203-261-8674
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	07/08/2007

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