MEDICARE: RACHELLE M NEIL

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	4504	UT

General Provider Information

NPI Number	:	1699819383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHELLE M NEIL

Provider Business Mailing Address
First Line	:	3220 S DURANGO DR
Second Line	:	SUITE B2
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-4409
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3220 S DURANGO DR
Second Line	:	SUITE B2
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-4409
Country	:	US
Telephone Number	:	702-795-2273
Fax Number	:

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

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	07/08/2007

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Directions to “ RACHELLE M NEIL ” Practice Location

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