MEDICARE: DONALD J. NEELY, DMD, MS, PC

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	1237	NH

General Provider Information

NPI Number	:	1851512180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONALD J. NEELY, DMD, MS, PC

Provider Business Mailing Address
First Line	:	7 ALLEN ST
Second Line	:	SUITE 300
City	:	HANOVER
State	:	NH
Zip	:	03755-2065
Country	:	US
Telephone Number	:	603-643-1200
Fax Number	:	603-643-9269

Provider Business Practice Location Address
First Line	:	7 ALLEN ST
Second Line	:	SUITE 300
City	:	HANOVER
State	:	NH
Zip	:	03755-2065
Country	:	US
Telephone Number	:	603-643-1200
Fax Number	:	603-643-9269

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DONALD J NEELY
Credential	:	DMD
Telephone Number	:	603-643-1200

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	08/22/2020

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