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DR. LUKE WILLIAM REVELT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
2800 COLLEGE AVE, ALTON, IL 62002-4742
(618) 474-7000
Mailing address
4 AZALEA CT, EDWARDSVILLE, IL 62025-3999

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019032795
IL

Other

Enumeration date
09/17/2020
Last updated
09/17/2020
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