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Individual

DR. DAVID J SLAGOWSKI

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3499 E FAIRVIEW AVE, MERIDIAN, ID 83642-5848
(208) 884-1362
Mailing address
1330 PRIMROSE LN, FOND DU LAC, WI 54935-1879
(208) 631-8529

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
3442-35
WI
152W00000X
Optometrist
Primary
ODP-1006
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
805533400
ID
Enumeration date
05/16/2006
Last updated
11/29/2017
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