Provider Demographics
NPI:1386759785
Name:SMITH, NEAL J (DDS)
Entity type:Individual
Prefix:DR
First Name:NEAL
Middle Name:J
Last Name:SMITH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14474 OAK PL
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-5929
Mailing Address - Country:US
Mailing Address - Phone:408-867-2877
Mailing Address - Fax:408-867-4939
Practice Address - Street 1:350 2ND ST
Practice Address - Street 2:SUITE #3
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-3695
Practice Address - Country:US
Practice Address - Phone:650-948-0200
Practice Address - Fax:650-949-0951
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21761122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist