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Organization
REVIVE DENTAL, PA
Active
Organization
REVIVE DENTAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YONG HO CHO DDS (PRESIDENT)
(415) 971-4727
Entity
Organization
Contact information
Practice address
3879 IRVING MALL, K-2A, IRVING, TX 75062-5159
(214) 574-4867
(469) 417-0802
Mailing address
2728 MCKINNON ST, APT 1517, DALLAS, TX 75201-1602
(415) 971-4727
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
27280
TX
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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