Provider Demographics
NPI:1174769285
Name:STEVE R. NEILL DDS PA
Entity type:Organization
Organization Name:STEVE R. NEILL DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:RALPH
Authorized Official - Last Name:NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-294-2402
Mailing Address - Street 1:302 N HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:PAOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66071-1304
Mailing Address - Country:US
Mailing Address - Phone:913-294-2402
Mailing Address - Fax:913-294-4067
Practice Address - Street 1:302 N HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-1304
Practice Address - Country:US
Practice Address - Phone:913-294-2402
Practice Address - Fax:913-294-4067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5148261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental