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NPI 1073574695

NPI 1073574695 : NEAL ALLAN STUBBS D.D.S.0517 : BRANDON, FL

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General NPI Number Information
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    NPI Number           |    1073574695
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    Entity Type          |    Individual 
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    Provider Name        |    NEAL ALLAN STUBBS D.D.S.0517
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/31/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    929 OAKFIELD DR 
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    City                 |    BRANDON
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    State                |    FL
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    Zip                  |    33511-4935
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    Country              |    US
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    Telephone            |    813-685-3511
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    Fax                  |    813-681-4879
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Provider Business Mailing Address
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    Address Line         |    929 OAKFIELD DR 
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    City                 |    BRANDON
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    State                |    FL
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    Zip                  |    33511-4935
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    Country              |    US
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    Telephone            |    813-685-3511
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    Fax                  |    813-681-4879
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    DN0007334
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    License Number State |    FL
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