Provider Demographics
NPI:1316036171
Name:ELAINE M NEAL DMD PA
Entity Type:Organization
Organization Name:ELAINE M NEAL DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-643-3509
Mailing Address - Street 1:73 LYME RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755
Mailing Address - Country:US
Mailing Address - Phone:603-643-3509
Mailing Address - Fax:603-643-3597
Practice Address - Street 1:73 LYME RD
Practice Address - Street 2:SUITE 3
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755
Practice Address - Country:US
Practice Address - Phone:603-643-3509
Practice Address - Fax:603-643-3597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2292122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty