# MEAD L. SLAGLE DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467940239
- **Authorized official:** JENNIFER WATERFIELD (OFFICE MANAGER)
- **Authorized official phone:** (252) 995-4101

## Contact information

- **Practice address:** 50716 HWY 12, FRISCO, NC 27936-0023
- **Practice address phone:** (252) 995-4101
- **Practice address fax:** (252) 995-4423
- **Mailing address:** PO BOX 967, BUXTON, NC 27920-0967
- **Mailing address phone:** (252) 995-4101
- **Mailing address fax:** (252) 995-4423

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6725 | NC | Yes |

## Other

- **Enumeration date:** 04/27/2018
- **Last updated:** 04/27/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 8990057 | — | NC |
| 01 | — | 90057 | BLUE CROSS BLUE SHIELD | NC |