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General NPI Number Information
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NPI Number | 1215004601
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Entity Type | Organization
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Legal Business Name | NEAL FAMILY DENTISTRY,D.D.S.,P.C.
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 901 ADAM DR
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City | CHILLICOTHEE
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State | MO
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Zip | 64601-3935
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Country | US
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Telephone | 660-646-4352
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Fax | 660-646-6282
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Provider Business Mailing Address
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Address Line | PO BOX 1050
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City | CHILLICOTHEE
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State | MO
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Zip | 64601-1050
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Country | US
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Telephone | 660-646-4352
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Fax | 660-646-6282
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID M NEAL
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Credential | DMD
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Telephone | 660-646-4352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 015513
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 013568
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License Number State | MO
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