Provider Demographics
NPI:1336272681
Name:DEEVERS, DEE ALLEN (DDS)
Entity Type:Individual
Prefix:
First Name:DEE
Middle Name:ALLEN
Last Name:DEEVERS
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 1:2651 N GREEN VALLEY PKY
Mailing Address - Street 2:103D
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014
Mailing Address - Country:US
Mailing Address - Phone:702-547-4653
Mailing Address - Fax:702-547-3846
Practice Address - Street 1:2651 N GREEN VALLEY PKY
Practice Address - Street 2:103D
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014
Practice Address - Country:US
Practice Address - Phone:702-547-4653
Practice Address - Fax:702-547-3846
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV27401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice