Provider Demographics
NPI:1891714812
Name:STEELY, KEVIN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:L
Last Name:STEELY
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 1:181 W EMMETT ST
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49037-2963
Mailing Address - Country:US
Mailing Address - Phone:269-966-2600
Mailing Address - Fax:269-965-4773
Practice Address - Street 1:181 W EMMETT ST
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49037-2963
Practice Address - Country:US
Practice Address - Phone:269-966-2600
Practice Address - Fax:269-965-4773
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5533015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist