Provider Demographics
NPI:1326045790
Name:NEILL, MARY ELIZABETH (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELIZABETH
Last Name:NEILL
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 WOODLORE RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-6569
Mailing Address - Country:US
Mailing Address - Phone:301-233-1297
Mailing Address - Fax:
Practice Address - Street 1:2311 M ST NW
Practice Address - Street 2:STE 500
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1495
Practice Address - Country:US
Practice Address - Phone:202-296-3360
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10000861223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics