Provider Demographics
NPI:1164161055
Name:HARVEY, ROBERT NEAL III (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NEAL
Last Name:HARVEY
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5540 CENTENNIAL BLVD APT 227
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-1484
Mailing Address - Country:US
Mailing Address - Phone:256-508-6414
Mailing Address - Fax:
Practice Address - Street 1:1821 BELTLINE RD SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-5606
Practice Address - Country:US
Practice Address - Phone:256-432-7063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD.007157-C1122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program