Provider Demographics
NPI:1609943786
Name:NEAL, DAVID M (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:NEAL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1050
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601-1050
Mailing Address - Country:US
Mailing Address - Phone:660-646-4352
Mailing Address - Fax:660-646-6282
Practice Address - Street 1:901 ADAM DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601-3935
Practice Address - Country:US
Practice Address - Phone:660-646-4352
Practice Address - Fax:660-646-6282
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0135681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice