Individual
DR. KEVIN JAY SHIVELY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12219 QUAKER AVE STE A, LUBBOCK, TX 79424-7783
(806) 698-8660
(806) 319-3878
Mailing address
12219 QUAKER AVE STE A, LUBBOCK, TX 79424-7783
(806) 698-8660
(806) 319-3878
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
34543
TX
Other
Enumeration date
08/02/2013
Last updated
03/17/2021
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