Thomas A Slack in Portage - Oral And Maxillofacial Surgery
Thomas A Slack - NPI 1669433793
Thomas A Slack is a Oral And Maxillofacial Surgery in Portage, Michigan. Thomas A Slack practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Thomas A Slack is 1669433793. The last update date is 2020-10-20.
Thomas A Slack's current location address is 3801 Glenkerry Ct, Portage, Michigan. You can contact this provider via phone number 2693231527 and fax number 2693231670. The mailing address for Thomas A Slack is 3801 Glenkerry Ct, Portage, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Thomas A Slack |
|---|---|
| Address | 3801 Glenkerry Ct, Portage, Michigan |
| Phone Number | 2693231527 |
| Fax Number | 2693231670 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1669433793 |
|---|---|
| Provider Enumeration Date | 2006-03-29 |
| Last Updated Date | 2020-10-20 |
Provider Mailing Address Detail
| Address | 3801 Glenkerry Ct |
|---|---|
| City | Portage |
| State | Michigan (MI) |
| Post Code | 490240718 |
| Phone Number | 2693231527 |
| Fax Number | 2693231670 |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
| Licence No | 2901013823 |
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Definition: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2675451 | MI | -- | |
| 2990919 | MI | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Thomas A Slack by the Centers for Medicare & Medicaid Services?
The Thomas A Slack has been issued the NPI (National Provider Identifier) 1669433793, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Thomas A Slack?
The Thomas A Slack is situated at 3801 Glenkerry Ct, in the city of Portage, state of MI, with the zip code 490240718.
What is Thomas A Slack's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Thomas A Slack is Oral And Maxillofacial Surgery, and the taxonomy code that classifies this field of practice is 1223S0112X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1669433793 to Thomas A Slack?
The Centers for Medicare & Medicaid Services originally issued the 1669433793 to Thomas A Slack on 2006-03-29.
When was the information pertaining to Thomas A Slack most recently updated or revised?
The details related to Thomas A Slack, including its address, specialty, and other relevant information, were last updated or revised on 2020-10-20.
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