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General NPI Number Information
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NPI Number | 1326045790
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Entity Type | Individual
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Provider Name | MARY ELIZABETH NEILL D.D.S., M.S.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2311 M ST NW STE 500
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City | WASHINGTON
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State | DC
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Zip | 20037-1495
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Country | US
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Telephone | 202-296-3360
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 WOODLORE RD
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City | ANNAPOLIS
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State | MD
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Zip | 21401-6569
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Country | US
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Telephone | 301-233-1297
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Fax |
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DEN1000086
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License Number State | DC
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