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Organization
REVIVE PERIODONTICS AND IMPLANTS
Active
Organization
REVIVE PERIODONTICS AND IMPLANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW GLOVER DDS (PRESIDENT)
(651) 334-2190
Entity
Organization
Contact information
Practice address
625 E NICOLLET BLVD STE 330, BURNSVILLE, MN 55337-6736
(952) 435-0333
Mailing address
625 E NICOLLET BLVD STE 330, BURNSVILLE, MN 55337-6736
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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