Provider Demographics
NPI:1548395650
Name:SUWAY, NEAL B (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:B
Last Name:SUWAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1214 FLEETWOOD RD
Mailing Address - Street 2:
Mailing Address - City:RYDAL
Mailing Address - State:PA
Mailing Address - Zip Code:19046-1808
Mailing Address - Country:US
Mailing Address - Phone:215-572-1079
Mailing Address - Fax:215-887-2968
Practice Address - Street 1:261 OLD YORK RD
Practice Address - Street 2:SUITE 329-A
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3706
Practice Address - Country:US
Practice Address - Phone:215-887-6060
Practice Address - Fax:215-887-2968
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-021819-L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics