Individual
DR. JOSEPH A. REVAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3421 SWEET AIR RD, JACKSONVILLE, MD 21131-1812
(410) 628-7050
(410) 628-1826
Mailing address
3421 SWEET AIR RD, JACKSONVILLE, MD 21131-1812
(410) 628-7050
(410) 628-1826
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6200
MD
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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