Provider Demographics
NPI:1578543005
Name:HARVEY, JONATHAN ROYLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ROYLE
Last Name:HARVEY
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 1:11605 MERIDIAN MARKET VIEW
Mailing Address - Street 2:SUITE 154
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831
Mailing Address - Country:US
Mailing Address - Phone:719-495-8989
Mailing Address - Fax:
Practice Address - Street 1:11605 MERIDIAN MARKET VIEW
Practice Address - Street 2:SUITE 154
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831
Practice Address - Country:US
Practice Address - Phone:719-495-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO95001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice