Provider Demographics
NPI:1184934663
Name:PAKETT, NEIL I (DMD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:I
Last Name:PAKETT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 FOXCROFT ROAD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1506
Mailing Address - Country:US
Mailing Address - Phone:610-623-7610
Mailing Address - Fax:610-284-9995
Practice Address - Street 1:43 S. LANSDOWNE AVE.
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050
Practice Address - Country:US
Practice Address - Phone:215-336-8873
Practice Address - Fax:610-623-0023
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019317L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice