Provider Demographics
NPI:1215326459
Name:NEILL, HUNTER (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:HUNTER
Middle Name:
Last Name:NEILL
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:HUNTER
Other - Middle Name:
Other - Last Name:NEILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:9201 LEESVILLE RD STE 160
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-7540
Mailing Address - Country:US
Mailing Address - Phone:919-844-8826
Mailing Address - Fax:
Practice Address - Street 1:9201 LEESVILLE RD STE 160
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-7540
Practice Address - Country:US
Practice Address - Phone:919-844-8826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104271223X0400X
PADS0402501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics