Provider Demographics
NPI:1346368180
Name:NEFF, ALVIN W (DDS FAGD)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:W
Last Name:NEFF
Suffix:
Gender:M
Credentials:DDS FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9830 OLD PRAIRIE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-9416
Mailing Address - Country:US
Mailing Address - Phone:479-636-6006
Mailing Address - Fax:
Practice Address - Street 1:110 S 20TH ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1101
Practice Address - Country:US
Practice Address - Phone:479-636-9688
Practice Address - Fax:479-986-0778
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR25571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR58957Medicare UPIN