Healthcare Provider Details

I. General information

NPI: 1073677894
Provider Name (Legal Business Name): DR. STEVEN P. NEVILLE, DMD, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S DIXIE ST
HORSE CAVE KY
42749-1230
US

IV. Provider business mailing address

311 S DIXIE ST P. O. BOX 324
HORSE CAVE KY
42749-1230
US

V. Phone/Fax

Practice location:
  • Phone: 270-786-2547
  • Fax: 270-786-4576
Mailing address:
  • Phone: 270-786-2547
  • Fax: 270-786-4576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN PIERCE NEVILLE
Title or Position: DENTIST
Credential: D.M.D.
Phone: 270-786-2547