Provider Demographics
NPI:1730280629
Name:NEAL, PAUL GRAYSON (DDS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:GRAYSON
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 1:806 WEST HAMLET AVE
Mailing Address - Street 2:
Mailing Address - City:HAMLET
Mailing Address - State:NC
Mailing Address - Zip Code:28345
Mailing Address - Country:US
Mailing Address - Phone:910-582-5143
Mailing Address - Fax:910-582-8620
Practice Address - Street 1:806 WEST HAMLET AVE
Practice Address - Street 2:
Practice Address - City:HAMLET
Practice Address - State:NC
Practice Address - Zip Code:28345
Practice Address - Country:US
Practice Address - Phone:910-582-5143
Practice Address - Fax:910-582-8620
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC39541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice