MEDICARE: DR. REBECCA MIRIAM SLOAN 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
1	122300000X	Dentist	30-24822	OH

General Provider Information

NPI Number	:	1700239282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA MIRIAM SLOAN DMD

Provider Business Mailing Address
First Line	:	1500 CANTON RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-4089
Country	:	US
Telephone Number	:	330-733-7911
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 CANTON RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-4089
Country	:	US
Telephone Number	:	330-733-7911
Fax Number	:

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

Provider Enumeration Date	:	07/19/2016
Last Update Date	:	07/19/2016

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