Whalio Doctors

NPI 1013438100

Bryce E Slack

Practitioner General Practice Dentistry Glendale, AZ

Practice location

Address
5400 W Northern Ave STE 202, Glendale, AZ 85301-1591
Phone
(623) 500-5793
Fax
(623) 321-1030
Mailing address
9169 W Alex Ave, Peoria, AZ 85382-8344

Registered specialties (2)

General Practice Dentistry Primary
Dental Providers Taxonomy 1223G0001X Licence D010940 (AZ)
General Practice Dentistry
Dental Providers Taxonomy 1223G0001X Licence 6979 (OK)

Registry record

NPI
1013438100
Entity type
Individual
Sex (as registered)
Male
NPI issued
29 Jun 2017
Record last updated
20 Feb 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.