MEDICARE: DR. JONATHAN CHRISTOPHER MCNEIL D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D9142	OR
2	1223G0001X	General Practice Dentistry	1331	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477718146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN CHRISTOPHER MCNEIL D.M.D.

Provider Business Mailing Address
First Line	:	3606 RHONE CIR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5049
Country	:	US
Telephone Number	:	907-646-8670
Fax Number	:	907-562-2170

Provider Business Practice Location Address
First Line	:	3606 RHONE CIR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5049
Country	:	US
Telephone Number	:	907-646-8670
Fax Number	:	907-562-2170

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2008
Last Update Date	:	04/23/2013

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