Provider Demographics
NPI:1891897849
Name:POTEAT, ROBERT MCNEILL (DDS,MS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MCNEILL
Last Name:POTEAT
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1061 BULLARD CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6801
Mailing Address - Country:US
Mailing Address - Phone:919-876-0030
Mailing Address - Fax:919-876-2563
Practice Address - Street 1:1061 BULLARD CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6801
Practice Address - Country:US
Practice Address - Phone:919-876-0030
Practice Address - Fax:919-876-2563
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC37101223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics