Individual
DR. BRADLEY DAVID REVENIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
BRANCH HEALTH CLINIC FALLON, 383 CHURCHILL AVE, FALLON, NV 89406
(775) 426-3164
Mailing address
NMRTU FALLON, 383 CHURCHILL AVE, FALLON, NV 89406
(775) 426-3164
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9872
AZ
Other
Enumeration date
09/26/2017
Last updated
07/10/2026
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