| Revive Dental, Pa | |
|
3879 Irving Mall K-2a Irving TX 75062-5159 | |
| (214) 574-4867 | |
| (469) 417-0802 |
| Full Name | Revive Dental, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3879 Irving Mall, Irving, Texas |
| Authorized Official Name and Position | Yong Ho Cho (PRESIDENT) |
| Authorized Official Contact | 4159714727 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Dental, Pa 2728 Mckinnon St Apt 1517 Dallas TX 75201-1602 Ph: (415) 971-4727 | Revive Dental, Pa 3879 Irving Mall K-2a Irving TX 75062-5159 Ph: (214) 574-4867 |
| NPI Number | 1184024887 |
|---|---|
| Provider Enumeration Date | 08/29/2014 |
| Last Update Date | 08/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184024887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 27280 (Texas) | Primary |
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