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General NPI Number Information
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NPI Number | 1730217019
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Entity Type | Individual
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Provider Name | WILLIAM D. NEALE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 824 EGLIN PKWY NE
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-2530
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Country | US
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Telephone | 850-244-3880
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Fax | 850-243-7438
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Provider Business Mailing Address
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Address Line | 21 PARADISE POINT RD
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City | SHALIMAR
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State | FL
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Zip | 32579-1019
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Country | US
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Telephone | 850-609-0419
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN 10584
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License Number State | FL
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