Provider Demographics
NPI:1235655812
Name:HUNTER NEILL DMD PC
Entity Type:Organization
Organization Name:HUNTER NEILL DMD PC
Other - Org Name:RALEIGH FAMILY ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:HUNTER
Authorized Official - Middle Name:
Authorized Official - Last Name:NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-844-8826
Mailing Address - Street 1:9201 LEESVILLE RD STE 160
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-7540
Mailing Address - Country:US
Mailing Address - Phone:919-844-8826
Mailing Address - Fax:
Practice Address - Street 1:9201 LEESVILLE RD STE 160
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-7540
Practice Address - Country:US
Practice Address - Phone:919-844-8826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104271223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty