Provider Demographics
NPI:1659550366
Name:ASBILL, KEVIN SHELLEY (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:SHELLEY
Last Name:ASBILL
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 1:2724 MIDDLEBURG DRIVE
Mailing Address - Street 2:MIDDLEBURG OFFICE PARK
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204
Mailing Address - Country:US
Mailing Address - Phone:803-256-7101
Mailing Address - Fax:803-256-7161
Practice Address - Street 1:2724 MIDDLEBURG DRIVE
Practice Address - Street 2:MIDDLEBURG OFFICE PARK
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204
Practice Address - Country:US
Practice Address - Phone:803-256-7101
Practice Address - Fax:803-256-7161
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC34291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice