Provider Demographics
NPI:1497942080
Name:NEAL, JEFFREY ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALLEN
Last Name:NEAL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 PALOS VERDES BLVD
Mailing Address - Street 2:NUMBER 7
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-6363
Mailing Address - Country:US
Mailing Address - Phone:310-594-1335
Mailing Address - Fax:
Practice Address - Street 1:350 PALOS VERDES BLVD
Practice Address - Street 2:NUMBER 7
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-6363
Practice Address - Country:US
Practice Address - Phone:310-594-1335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA400971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice