| Jessica Russo Revand, Dmd, Ms, Pllc | |
|
8987 Hersand Dr Ste 3 Burke VA 22015-1604 | |
| (703) 503-0555 | |
| Not Available |
| Full Name | Jessica Russo Revand, Dmd, Ms, Pllc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 8987 Hersand Dr Ste 3, Burke, Virginia |
| Authorized Official Name and Position | Jessica Russo Revand (OWNER/ENDODONTIST) |
| Authorized Official Contact | 7035030555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Russo Revand, Dmd, Ms, Pllc 10603 Oliver St Fairfax VA 22030-3913 Ph: (202) 270-4779 | Jessica Russo Revand, Dmd, Ms, Pllc 8987 Hersand Dr Ste 3 Burke VA 22015-1604 Ph: (703) 503-0555 |
| NPI Number | 1669060364 |
|---|---|
| Provider Enumeration Date | 01/07/2021 |
| Last Update Date | 01/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669060364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | (* (Not Available)) | Primary |
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