Provider Demographics
NPI:1386373736
Name:R DEAN MCNEAL DDS PA
Entity type:Organization
Organization Name:R DEAN MCNEAL DDS PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:IRONSIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-871-3488
Mailing Address - Street 1:754 S MAIN ST STE 5
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-5519
Mailing Address - Country:US
Mailing Address - Phone:435-652-1445
Mailing Address - Fax:
Practice Address - Street 1:3394 N FUTRALL DR STE 2
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-3937
Practice Address - Country:US
Practice Address - Phone:479-582-3360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty