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Individual

DR. WENDELL WAYNE NEELEY II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD, MD, MS

Contact information

Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 813-2625
Mailing address
706 DELAWARE ST, SHREVEPORT, LA 71106-1640
(210) 378-2475

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
S-800
LA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
20792
TX

Other

Enumeration date
03/24/2008
Last updated
09/04/2014
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