Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DN0007334 | FL |
NPI | 1073574695 |
---|---|
Provider Name | Dr. Neal Allan Stubbs |
First Address | Brandon, FL 33511-4935 |
Second Address | Brandon, FL 33511-4935 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 08/07/2007 |