Provider Demographics
NPI:1295897387
Name:STARKEY, NEIL A (DDS)
Entity type:Individual
Prefix:MR
First Name:NEIL
Middle Name:A
Last Name:STARKEY
Suffix:
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 1:1002 N EATON ST
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:MI
Mailing Address - Zip Code:49224-1109
Mailing Address - Country:US
Mailing Address - Phone:517-629-5508
Mailing Address - Fax:517-629-7061
Practice Address - Street 1:1002 N EATON ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:MI
Practice Address - Zip Code:49224-1109
Practice Address - Country:US
Practice Address - Phone:517-629-5508
Practice Address - Fax:517-629-7016
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI12245122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4050314Medicaid