Provider Demographics
NPI:1699974303
Name:SLEILATI, JOSEPH C (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:SLEILATI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 WEST ST
Mailing Address - Street 2:STE 102
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3401
Mailing Address - Country:US
Mailing Address - Phone:410-268-4770
Mailing Address - Fax:
Practice Address - Street 1:201 WEST ST
Practice Address - Street 2:STE 102
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3401
Practice Address - Country:US
Practice Address - Phone:410-268-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054110122300000X
MD151391223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist