Provider Demographics
NPI:1467548537
Name:GITTLEMAN, NEAL BRUCE (DMD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:BRUCE
Last Name:GITTLEMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:50 BRIAR HOLLOW LN
Mailing Address - Street 2:SUITE 150 WEST
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-9300
Mailing Address - Country:US
Mailing Address - Phone:713-993-0003
Mailing Address - Fax:713-993-0223
Practice Address - Street 1:50 BRIAR HOLLOW LN
Practice Address - Street 2:SUITE 150 WEST
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-9300
Practice Address - Country:US
Practice Address - Phone:713-993-0003
Practice Address - Fax:713-993-0223
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX138761223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics