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Individual

DR. TERRY W. SLAUGHTER W SLAUGHTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS MSD

Contact information

Practice address
901 SUNSET DR, STE 5, HOLLISTER, CA 95023-5613
(831) 636-8484
(831) 636-8244
Mailing address
901 SUNSET DR, STE 5, HOLLISTER, CA 95023-5613
(831) 636-8484
(831) 636-8244

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
16053
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16053
DENTAL LICENSE
CA
01
DS160531
MEDICARE
CA
Enumeration date
07/23/2007
Last updated
07/23/2007
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