MEDICARE: DR. ROBERT G MCNEILL D.D.S., 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	21642	TX

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	:	1881638989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT G MCNEILL D.D.S., M.D.

Provider Business Mailing Address
First Line	:	3132 PURDUE AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225-7721
Country	:	US
Telephone Number	:	972-272-8751
Fax Number	:	972-272-8752

Provider Business Practice Location Address
First Line	:	1530 FOREST LN S
Second Line	:	STE D
City	:	GARLAND
State	:	TX
Zip	:	75042-7950
Country	:	US
Telephone Number	:	972-272-8751
Fax Number	:	972-272-8752

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

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	01/21/2011

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Directions to “ DR. ROBERT G MCNEILL D.D.S., M.D.” Practice Location

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