Organization
MEAD L. SLAGLE DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER WATERFIELD (OFFICE MANAGER)
(252) 995-4101
Entity
Organization
Contact information
Practice address
50716 HWY 12, FRISCO, NC 27936-0023
(252) 995-4101
(252) 995-4423
Mailing address
PO BOX 967, BUXTON, NC 27920-0967
(252) 995-4101
(252) 995-4423
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6725
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8990057
—
NC
01
—
90057
BLUE CROSS BLUE SHIELD
NC
Enumeration date
04/27/2018
Last updated
04/27/2018
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