Provider Demographics
NPI:1427277649
Name:ADELA SLATON DDS INC
Entity type:Organization
Organization Name:ADELA SLATON DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SLATON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-312-5888
Mailing Address - Street 1:617 S EIGHTH ST
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243
Mailing Address - Country:US
Mailing Address - Phone:760-312-5888
Mailing Address - Fax:760-312-5918
Practice Address - Street 1:617 S EIGHTH ST
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243
Practice Address - Country:US
Practice Address - Phone:760-312-5888
Practice Address - Fax:760-312-5918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44262122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2504OtherDHS DENTAL HEALTH SERVICE
CAB4426202OtherMEDI CAL STATE OF CALIFOR