Provider Demographics
NPI:1225018450
Name:NEVILS, MARIA MARIBEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:MARIBEL
Last Name:NEVILS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:MARIBEL
Other - Last Name:NEVILS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 58372
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-8372
Mailing Address - Country:US
Mailing Address - Phone:910-797-8978
Mailing Address - Fax:
Practice Address - Street 1:610 GLENVILLE AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4840
Practice Address - Country:US
Practice Address - Phone:910-797-8978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8016122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1225018450OtherUS GOVERNMENT