Provider Demographics
NPI:1720298334
Name:H.WAYNE NEAVILLE DDS PA
Entity Type:Organization
Organization Name:H.WAYNE NEAVILLE DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:NEAVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-623-9882
Mailing Address - Street 1:2212 MALVERN AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-8038
Mailing Address - Country:US
Mailing Address - Phone:501-623-9882
Mailing Address - Fax:501-623-8424
Practice Address - Street 1:2212 MALVERN AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-8038
Practice Address - Country:US
Practice Address - Phone:501-623-9882
Practice Address - Fax:501-623-8424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR18811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty