Provider Demographics
NPI:1962715227
Name:SLOAT, GEOFFREY CAMERON (DDS)
Entity type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:CAMERON
Last Name:SLOAT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:CAMERON
Other - Middle Name:
Other - Last Name:SLOAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1713 NW 146TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-2490
Mailing Address - Country:US
Mailing Address - Phone:405-315-8904
Mailing Address - Fax:
Practice Address - Street 1:6616 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1708
Practice Address - Country:US
Practice Address - Phone:405-601-7852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK62301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice