Individual
DR. JACK MONROE NEAGLE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1805 W WHITE OAK TER, SUITE C, CONROE, TX 77304-3590
(936) 539-2980
(936) 539-2969
Mailing address
1805 W WHITE OAK TER, SUITE C, CONROE, TX 77304-3590
(936) 539-2980
(936) 539-2969
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
22205 DENTAL
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2765224960
MYUTMB 2765224960-COMMERCIAL NUMBER
—
Enumeration date
06/14/2007
Last updated
06/08/2009
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