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NPI Code Detail

MEDICARE: DR. WILLIAM D. NEALE D.D.S.

MEDICARE:  DR. WILLIAM D. NEALE  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryDN 10584FL

General Provider Information

NPI Number : 1730217019
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM D. NEALE D.D.S.
Provider Business Mailing Address
First Line : 21 PARADISE POINT RD
Second Line :
City : SHALIMAR
State : FL
Zip : 32579-1019
Country : US
Telephone Number : 850-609-0419
Fax Number :
Provider Business Practice Location Address
First Line : 824 EGLIN PKWY NE
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32547-2530
Country : US
Telephone Number : 850-244-3880
Fax Number : 850-243-7438
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 10/14/2020

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