# PAUL D. REVARD D.D.S.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083055289
- **Authorized official:** DR. PAUL DOUGLAS REVARD D.D.S. (OWNER)
- **Authorized official phone:** (989) 893-2140

## Contact information

- **Practice address:** 916 WASHINGTON AVE., SUITE 215, BAY CITY, MI 48708
- **Practice address phone:** (989) 893-2140
- **Practice address fax:** (989) 893-0423
- **Mailing address:** 916 WASHINGTON AVE, SUITE 215, BAY CITY, MI 48708
- **Mailing address phone:** (989) 893-2140
- **Mailing address fax:** (989) 893-2140

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 07/16/2013
- **Last updated:** 07/16/2013