Healthcare Provider Details

I. General information

NPI: 1972956423
Provider Name (Legal Business Name): MILES F. NEFF, DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 07/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 COLBY AVE STE 3
EVERETT WA
98201-4399
US

IV. Provider business mailing address

3230 COLBY AVE STE 3
EVERETT WA
98201-4399
US

V. Phone/Fax

Practice location:
  • Phone: 425-252-0111
  • Fax: 425-252-1119
Mailing address:
  • Phone: 425-252-0111
  • Fax: 425-252-1119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5298
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number4260
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number4909
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number4741
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number60055086
License Number StateWA

VIII. Authorized Official

Name: DR. MILES F NEFF
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 425-252-0111