Provider Demographics
NPI:1144343351
Name:HARVEY, JEFFREY TODD (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:TODD
Last Name:HARVEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:JEFFREY
Other - Middle Name:T
Other - Last Name:HARVEY
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 568
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:KY
Mailing Address - Zip Code:42135-0568
Mailing Address - Country:US
Mailing Address - Phone:270-598-0508
Mailing Address - Fax:270-586-0924
Practice Address - Street 1:320 MCLENDON RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:KY
Practice Address - Zip Code:42134-1954
Practice Address - Country:US
Practice Address - Phone:270-598-0508
Practice Address - Fax:270-586-0924
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY68791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice