Provider Demographics
NPI:1962059899
Name:SLATTERY, JAMES SPENCER JR (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SPENCER
Last Name:SLATTERY
Suffix:JR
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 1:803 WOLLASTON RD
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1478
Mailing Address - Country:US
Mailing Address - Phone:302-222-2367
Mailing Address - Fax:
Practice Address - Street 1:687 UNIONVILLE RD
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-4717
Practice Address - Country:US
Practice Address - Phone:610-444-0750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0422871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice