# J2DENTAL, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** REVIVE DENTISTRY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639980717
- **Authorized official:** DR. JAMES TANGALOS DMD (DENTIST)
- **Authorized official phone:** (586) 854-3814

## Contact information

- **Practice address:** 51540 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48316-4446
- **Practice address phone:** (586) 731-7730
- **Mailing address:** 51540 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48316-4446
- **Mailing address phone:** (586) 731-7730

## Taxonomy

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

## Other

- **Enumeration date:** 01/16/2025
- **Last updated:** 01/16/2025