Organization
GARY L. REVERCOMB, DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY L REVERCOMB DMD (DENTIST)
(315) 682-8400
Entity
Organization
Contact information
Practice address
8076 CAZENOVIA RD, MANLIUS, NY 13104-9218
(315) 682-8400
(315) 682-2602
Mailing address
8076 CAZENOVIA RD, MANLIUS, NY 13104-9218
(315) 682-8400
(315) 682-2602
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
030581
NY
Other
Enumeration date
04/27/2011
Last updated
04/27/2011
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