Provider Demographics
NPI:1528126984
Name:MCNEAL, GREGG F (DDS)
Entity type:Individual
Prefix:DR
First Name:GREGG
Middle Name:F
Last Name:MCNEAL
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 1:643 CAPE CORAL PKWY E
Mailing Address - Street 2:#A
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-8549
Mailing Address - Country:US
Mailing Address - Phone:239-542-1800
Mailing Address - Fax:
Practice Address - Street 1:643 CAPE CORAL PKWY E
Practice Address - Street 2:#A
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-8549
Practice Address - Country:US
Practice Address - Phone:239-542-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 000 95141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice