Provider Demographics
NPI:1609079995
Name:NEHL, MIKE E (DDS)
Entity Type:Individual
Prefix:
First Name:MIKE
Middle Name:E
Last Name:NEHL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:BELLE FOURCHE
Mailing Address - State:SD
Mailing Address - Zip Code:57717-1428
Mailing Address - Country:US
Mailing Address - Phone:605-892-3603
Mailing Address - Fax:
Practice Address - Street 1:605 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:BELLE FOURCHE
Practice Address - State:SD
Practice Address - Zip Code:57717-1428
Practice Address - Country:US
Practice Address - Phone:605-892-3603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM6501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice