Provider Demographics
NPI:1629127204
Name:PEARSON, NEAL H (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:H
Last Name:PEARSON
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 1:508 ESTUDILLO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4612
Mailing Address - Country:US
Mailing Address - Phone:510-483-6351
Mailing Address - Fax:510-483-6304
Practice Address - Street 1:508 ESTUDILLO AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4612
Practice Address - Country:US
Practice Address - Phone:510-483-6351
Practice Address - Fax:510-483-6304
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA229111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice