Provider Demographics
NPI:1497954986
Name:RHEA, NEALE EDWARD JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:NEALE
Middle Name:EDWARD
Last Name:RHEA
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:2642 OLD ROCKY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4806
Mailing Address - Country:US
Mailing Address - Phone:205-987-1611
Mailing Address - Fax:205-987-1614
Practice Address - Street 1:2642 OLD ROCKY RIDGE RD
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35216-4806
Practice Address - Country:US
Practice Address - Phone:205-987-1611
Practice Address - Fax:205-987-1614
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2011-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL44031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510 30040OtherBLUE CROSS BLUE SHIELD
AL009933148Medicaid
709254OtherUNITED CONCORDIA