Provider Demographics
NPI:1336465657
Name:NEAVES, ARMIDA L (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARMIDA
Middle Name:L
Last Name:NEAVES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ARMIDA
Other - Middle Name:L
Other - Last Name:NEAVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:6465 ALTA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:WATAUGA
Mailing Address - State:TX
Mailing Address - Zip Code:76148-1410
Mailing Address - Country:US
Mailing Address - Phone:817-915-5706
Mailing Address - Fax:
Practice Address - Street 1:6465 ALTA VISTA DR
Practice Address - Street 2:
Practice Address - City:WATAUGA
Practice Address - State:TX
Practice Address - Zip Code:76148-1410
Practice Address - Country:US
Practice Address - Phone:817-915-5706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX158641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice