Basic Information
Provider Information
NPI: 1003003633
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SLAUGHTER
FirstName: LISA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 311 ROUTE 108
Address2:  
City: SOMERSWORTH
State: NH
PostalCode: 038781522
CountryCode: US
TelephoneNumber: 6037492346
FaxNumber: 6039530066
Practice Location
Address1: 311 ROUTE 108
Address2:  
City: SOMERSWORTH
State: NH
PostalCode: 038781522
CountryCode: US
TelephoneNumber: 6037492346
FaxNumber: 6039530066
Other Information
ProviderEnumerationDate: 09/27/2007
LastUpdateDate: 06/22/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X03690NHY Dental ProvidersDentist 

No ID Information.


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