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General NPI Number Information
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NPI Number | 1760034144
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Entity Type | Individual
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Provider Name | CODY ALAN NEILL DMD
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Gender | Male
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Dates
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Enumeration Date | 07/15/2019
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 1123 ASHLEY RIVER RD
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City | CHARLESTON
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State | SC
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Zip | 29407-7101
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Country | US
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Telephone | 843-402-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 1538 BANNING ST
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City | MT PLEASANT
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State | SC
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Zip | 29466-7505
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Country | US
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Telephone | 910-224-1655
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 10047
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License Number State | SC
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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 | 24317
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License Number State | FL
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