Individual
MR. REVENEL REVERT METAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2570 BLACKMON DR STE 310, DECATUR, GA 30033-6197
(678) 203-3462
Mailing address
2570 BLACKMON DR STE 310, DECATUR, GA 30033-6197
(239) 206-9099
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN123860
GA
Other
Enumeration date
03/12/2024
Last updated
07/18/2025
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