Provider Demographics
NPI:1649266206
Name:NEVILLS, DAVID E (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:NEVILLS
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 1:18540 SW VINCENT ST
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97078-1578
Mailing Address - Country:US
Mailing Address - Phone:503-649-3232
Mailing Address - Fax:503-649-0362
Practice Address - Street 1:18540 SW VINCENT ST
Practice Address - Street 2:
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97078-1578
Practice Address - Country:US
Practice Address - Phone:503-649-3232
Practice Address - Fax:503-649-0362
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD60951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice