Provider Demographics
NPI:1457845679
Name:MCNEELEY, ALEXANDER JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:JAMES
Last Name:MCNEELEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10305 DOVER ST APT 1114
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3973
Mailing Address - Country:US
Mailing Address - Phone:517-281-6745
Mailing Address - Fax:
Practice Address - Street 1:306 CENTER DR
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-8625
Practice Address - Country:US
Practice Address - Phone:303-449-9555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00203606122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist