Provider Demographics
NPI:1760689848
Name:MCNEILL, BYRON LAWRENCE JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:LAWRENCE
Last Name:MCNEILL
Suffix:JR
Gender:M
Credentials:DDS
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Mailing Address - Street 1:2901 BREEZEWOOD AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-5409
Mailing Address - Country:US
Mailing Address - Phone:910-323-0089
Mailing Address - Fax:910-323-0824
Practice Address - Street 1:2901 BREEZEWOOD AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5409
Practice Address - Country:US
Practice Address - Phone:910-323-0089
Practice Address - Fax:910-323-0824
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NC42761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice