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Organization
REVEL DENTAL,PSC
Active
Organization
REVEL DENTAL,PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA A REVEL DMD (PRES.)
(859) 887-3835
Entity
Organization
Contact information
Practice address
210 BELLAIRE DR, NICHOLASVILLE, KY 40356-8840
(859) 887-3835
(859) 887-0351
Mailing address
210 BELLAIRE DR, NICHOLASVILLE, KY 40356-8840
(895) 887-3835
(859) 887-0351
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7128
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100186980
—
KY
Enumeration date
02/07/2012
Last updated
02/07/2012
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