Provider Demographics
NPI:1992772727
Name:SLASON, LORRAINE LEWIS
Entity type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:LEWIS
Last Name:SLASON
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:LORRAINE
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:407 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-5121
Mailing Address - Country:US
Mailing Address - Phone:508-430-8172
Mailing Address - Fax:508-771-2569
Practice Address - Street 1:407 NORTH ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5121
Practice Address - Country:US
Practice Address - Phone:508-430-8172
Practice Address - Fax:508-771-2569
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA192001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry