Organization
REVIVAL DENTISTRY LLC
Active
Other names
Palos Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZACHARY YOUNG DDS (DENTIST/OWNER)
(309) 207-0112
Entity
Organization
Contact information
Practice address
7132 W 127TH ST, PALOS HEIGHTS, IL 60463-1560
(309) 207-0112
Mailing address
7132 W 127TH ST, PALOS HEIGHTS, IL 60463-1560
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/08/2020
Last updated
01/08/2020
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