Provider Demographics
NPI:1851661375
Name:NEVY, KRISTINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:
Last Name:NEVY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RIDGE RD
Mailing Address - Street 2:SUITE 36
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9784
Mailing Address - Country:US
Mailing Address - Phone:610-558-1760
Mailing Address - Fax:
Practice Address - Street 1:100 RIDGE RD
Practice Address - Street 2:SUITE 36
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9784
Practice Address - Country:US
Practice Address - Phone:610-558-1760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS 035500122300000X
MD12966122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist