# NORTHSIDE ENDODONTICS, PC

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

## Provider details

- **NPI number:** 1588810980
- **Authorized official:** DR. JOHN H SLAVENS DDS,MSD (OWNER)
- **Authorized official phone:** (795) 759-9630

## Contact information

- **Practice address:** 1400 S PILGRIM BLVD, YORKTOWN, IN 47396-9250
- **Practice address phone:** (765) 759-9630
- **Practice address fax:** (765) 759-9640
- **Mailing address:** 1400 S PILGRIM BLVD, YORKTOWN, IN 47396-9250
- **Mailing address phone:** (765) 759-9630
- **Mailing address fax:** (765) 759-9640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 54000837A | IN | Yes |

## Other

- **Enumeration date:** 08/18/2008
- **Last updated:** 08/18/2008