Provider Demographics
NPI:1922110121
Name:NEALE, WILLIAM SAMUEL (BA, DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SAMUEL
Last Name:NEALE
Suffix:
Gender:M
Credentials:BA, DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 AMHERST DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-5325
Mailing Address - Country:US
Mailing Address - Phone:940-322-0758
Mailing Address - Fax:940-322-0909
Practice Address - Street 1:2625 AMHERST DR
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-5325
Practice Address - Country:US
Practice Address - Phone:940-322-0758
Practice Address - Fax:940-322-0909
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
TX132671223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics