Revive Dental, Pa

NPI 1184024887 - Dentist - 1223G0001X

NPI Details
NPI 1184024887
Enumeration Date 08/29/2014
Last Updated 08/29/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name YONG HO YONG HO
Position PRESIDENT
Phone (214) 574-4867
Fax (469) 417-0802
Practice Location
3879 IRVING MALL
K-2A
IRVING TX, 75062-5159, US
Phone (214) 574-4867
Fax (469) 417-0802
Business Location
2728 MCKINNON ST
APT 1517
DALLAS TX, 75201-1602, US
Phone (415) 971-4727
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Texas
License Number 27280
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According to our database, Revive Dental, Pa NPI is 1184024887, taxonomy code is 1223G0001X and license number is 27280, license state is located at Texas. Revive Dental, Pa physically located at 3879 Irving Mall, Irving TX, 75062-5159. NPI Number 1033115704 has the healthcare provider type.

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1184024887 NPI number is provided on an as is basis without warranty of any kind. 1184024887 is maintained by the National Plan & Provider Enumeration System. The contents of Revive Dental, Pa are for informational purposes only.