MEDICARE: DR. NEAL S SLUTSKY D.M.D.

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	22D101296900	NJ

General Provider Information

NPI Number	:	1558518902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEAL S SLUTSKY D.M.D.

Provider Business Mailing Address
First Line	:	658 W CUTHBERT BLVD
Second Line	:
City	:	HADDON TOWNSHIP
State	:	NJ
Zip	:	08108-3642
Country	:	US
Telephone Number	:	856-869-8660
Fax Number	:	856-869-8686

Provider Business Practice Location Address
First Line	:	658 W CUTHBERT BLVD
Second Line	:
City	:	HADDON TOWNSHIP
State	:	NJ
Zip	:	08108-3642
Country	:	US
Telephone Number	:	856-869-8660
Fax Number	:	856-869-8686

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

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	08/27/2008

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