Provider Demographics
NPI:1699784595
Name:LOCKER, NEAL H (DMD)
Entity type:Individual
Prefix:DR
First Name:NEAL
Middle Name:H
Last Name:LOCKER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:NEAL
Other - Middle Name:H
Other - Last Name:LOCKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:510 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-1414
Mailing Address - Country:US
Mailing Address - Phone:814-330-4103
Mailing Address - Fax:814-693-6647
Practice Address - Street 1:510 3RD AVE
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-1414
Practice Address - Country:US
Practice Address - Phone:814-330-4103
Practice Address - Fax:814-693-6647
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025561L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice