Provider Demographics
NPI:1063592830
Name:SLAYBAUGH, DANIEL SCOTT (DMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:SCOTT
Last Name:SLAYBAUGH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28467 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-4333
Mailing Address - Country:US
Mailing Address - Phone:727-725-2439
Mailing Address - Fax:727-725-5077
Practice Address - Street 1:28467 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 301
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-4333
Practice Address - Country:US
Practice Address - Phone:727-725-2439
Practice Address - Fax:727-725-5077
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN154961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice