Provider Demographics
NPI:1790030898
Name:NEAL, ROBIN C (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:C
Last Name:NEAL
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 1:154 GIBBS ST
Mailing Address - Street 2:UNIT 313
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-0355
Mailing Address - Country:US
Mailing Address - Phone:623-523-3379
Mailing Address - Fax:
Practice Address - Street 1:PENTAGON TRI SERVICE DENTAL
Practice Address - Street 2:5802 ARMY PENTAGON
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20310-0001
Practice Address - Country:US
Practice Address - Phone:703-692-8748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00201801122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist