Provider Demographics
NPI:1487824074
Name:NEIL D DEMAREE DDS PC
Entity Type:Organization
Organization Name:NEIL D DEMAREE DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:DEMAREE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:276-783-8611
Mailing Address - Street 1:322 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-3300
Mailing Address - Country:US
Mailing Address - Phone:276-783-8611
Mailing Address - Fax:
Practice Address - Street 1:322 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-3300
Practice Address - Country:US
Practice Address - Phone:276-783-8611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010064231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty