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Individual

MRS. MARTA REVILLA-LEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS, MSD

Contact information

Practice address
3302 GASTON AVENUE, COLLEGE OF DENTISTRY, TEXAS A&M UNI, ROOM 713, DALLAS, TX 75246
(214) 828-8408
Mailing address
3302 GASTON AVENUE, COLLEGE DENTISTRY, TEXAS A&M UNIVER, ROOM 713, DALLAS, TX 75246
(214) 828-8408

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
34706
TX

Other

Enumeration date
01/16/2019
Last updated
01/16/2019
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