Provider Demographics
NPI:1215004601
Name:NEAL FAMILY DENTISTRY,D.D.S.,P.C.
Entity Type:Organization
Organization Name:NEAL FAMILY DENTISTRY,D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:660-646-4352
Mailing Address - Street 1:PO BOX 1050
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601-1050
Mailing Address - Country:US
Mailing Address - Phone:660-646-4352
Mailing Address - Fax:660-646-6282
Practice Address - Street 1:901 ADAM DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601-3935
Practice Address - Country:US
Practice Address - Phone:660-646-4352
Practice Address - Fax:660-646-6282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO013568122300000X
MO015513122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty