Organization · Type 2 NPI
Revere Dental
Dental Clinic/Center · Bourbonnais, IL
NPI number
1790479210
Active
Practice location
588 William Latham Dr Ste 2
Bourbonnais, IL 60914-2340
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
Other dental clinic/center providers in Bourbonnais
About NPI 1790479210
Revere Dental's National Provider Identifier is 1790479210, issued on Jun 7, 2023. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Bourbonnais, IL. The record was last updated on Jun 7, 2023.