Provider Demographics
NPI:1235354168
Name:NEVILLE, JEFFRY J (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFRY
Middle Name:J
Last Name:NEVILLE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 N KING ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041
Mailing Address - Country:US
Mailing Address - Phone:801-543-2273
Mailing Address - Fax:801-991-2993
Practice Address - Street 1:743 N KING ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041
Practice Address - Country:US
Practice Address - Phone:801-543-2273
Practice Address - Fax:801-991-2993
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT574333799221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice