| Revere Dental | |
|
588 William Latham Dr Ste 2 Bourbonnais IL 60914-2340 | |
| (815) 933-6100 | |
| Not Available |
| Full Name | Revere Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 588 William Latham Dr Ste 2, Bourbonnais, Illinois |
| Authorized Official Name and Position | Peter Girgis (DENTIST) |
| Authorized Official Contact | 8159336100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revere Dental 588 William Latham Dr Ste 2 Bourbonnais IL 60914-2340 Ph: () - | Revere Dental 588 William Latham Dr Ste 2 Bourbonnais IL 60914-2340 Ph: (815) 933-6100 |
| NPI Number | 1790479210 |
|---|---|
| Provider Enumeration Date | 06/07/2023 |
| Last Update Date | 06/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790479210 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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