Healthcare Provider Details

I. General information

NPI: 1295710713
Provider Name (Legal Business Name): JOHN JEFFREY NEAL DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 09/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

310 MISTY KNOLL DR
ROCKVILLE MD
20850-2878
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-0064
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number12010753A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: