Healthcare Provider Details

I. General information

NPI: 1710041538
Provider Name (Legal Business Name): STEVEN PIERCE NEVILLE D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 05/08/2008
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:
Mailing address:
  • Phone: 270-786-2547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4965
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: