Provider Demographics
NPI:1710041538
Name:NEVILLE, STEVEN PIERCE (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:PIERCE
Last Name:NEVILLE
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 1:311 S DIXIE ST
Mailing Address - Street 2:P.O. BOX 324
Mailing Address - City:HORSE CAVE
Mailing Address - State:KY
Mailing Address - Zip Code:42749-1230
Mailing Address - Country:US
Mailing Address - Phone:270-786-2547
Mailing Address - Fax:
Practice Address - Street 1:311 S DIXIE ST
Practice Address - Street 2:
Practice Address - City:HORSE CAVE
Practice Address - State:KY
Practice Address - Zip Code:42749-1230
Practice Address - Country:US
Practice Address - Phone:270-786-2547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4965122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60049657Medicaid