Individual
DR. ROLAND FRED SLYBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3615 LAKE AVE, FORT WAYNE, IN 46805-5539
(260) 424-6373
Mailing address
3615 LAKE AVE, FORT WAYNE, IN 46805-5539
(260) 424-6373
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12006426
IN
Other
Enumeration date
08/08/2006
Last updated
07/08/2007
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