Provider Demographics
NPI:1073574695
Name:STUBBS, NEAL ALLAN (DDS0517)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:ALLAN
Last Name:STUBBS
Suffix:
Gender:M
Credentials:DDS0517
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 OAKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4935
Mailing Address - Country:US
Mailing Address - Phone:813-685-3511
Mailing Address - Fax:813-681-4879
Practice Address - Street 1:929 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4935
Practice Address - Country:US
Practice Address - Phone:813-685-3511
Practice Address - Fax:813-681-4879
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00073341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics