Provider Demographics
NPI:1851464770
Name:MCNEELY, DAVID E JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:MCNEELY
Suffix:JR
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 1:1014 WEST G STREET
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37643
Mailing Address - Country:US
Mailing Address - Phone:423-542-9419
Mailing Address - Fax:423-542-9421
Practice Address - Street 1:1014 WEST G STREET
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643
Practice Address - Country:US
Practice Address - Phone:423-542-9419
Practice Address - Fax:423-542-9421
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS3783122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist