Individual
KATHLEEN ANN REVELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1100 E VERONA AVE, VERONA, WI 53593-8717
(608) 845-6601
(608) 845-1264
Mailing address
1100 E VERONA AVE, VERONA, WI 53593-8717
(608) 845-6601
(608) 845-1264
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4036-16
WI
Other
Enumeration date
05/05/2022
Last updated
05/05/2022
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