# REVIVE DENTAL LIVONIA

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

## Provider details

- **NPI number:** 1679464507
- **Authorized official:** VINCENT DAWISHA DDS (PARTNER)
- **Authorized official phone:** (248) 444-3847

## Contact information

- **Practice address:** 31544 SCHOOLCRAFT RD, LIVONIA, MI 48150-1805
- **Practice address phone:** (248) 943-0907
- **Mailing address:** 31544 SCHOOLCRAFT RD, LIVONIA, MI 48150-1805

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 07/10/2025
- **Last updated:** 07/10/2025