Individual
ELEANOR MARIA REVELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
7631 CASS ST, OMAHA, NE 68114-3623
(402) 393-0594
Mailing address
N9023 LAKESHORE RD, SHEBOYGAN, WI 53083-5123
(920) 918-5399
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
00206047
CO
122300000X
Dentist
Primary
8068
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/20/2024
Last updated
04/07/2025
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