Individual
DR. MICHELE MARIE REVOIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
17565 CENTRAL AVE NE, HAM LAKE, MN 55304
(763) 434-4188
(763) 413-7261
Mailing address
17565 CENTRAL AVE NE, HAM LAKE, MN 55304
(763) 434-4188
(763) 413-7261
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10416
MN
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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