Individual
DR. JOHNNY DEE NEELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1491 CANTON MART RD, BUILDING A SUITE C, JACKSON, MS 39211-5411
(601) 991-0044
Mailing address
1491 CANTON MART RD, BUILDING A SUITE C, JACKSON, MS 39211-5411
(601) 991-0044
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2192-85
MS
Other
Enumeration date
11/07/2006
Last updated
07/08/2007
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