Provider Demographics
NPI:1447526389
Name:DAVID C. SLAWISNKI DDS, PA
Entity type:Organization
Organization Name:DAVID C. SLAWISNKI DDS, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SLAWINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-803-1595
Mailing Address - Street 1:5041 SIX FORKS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4494
Mailing Address - Country:US
Mailing Address - Phone:919-803-1595
Mailing Address - Fax:919-803-8363
Practice Address - Street 1:5041 SIX FORKS RD STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4494
Practice Address - Country:US
Practice Address - Phone:919-803-1595
Practice Address - Fax:919-803-8363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5918868Medicaid