DR. Michele Marie Revoir, DDS

NPI #1205987872 in Ham Lake, Minnesota

Provider Information

NPI Number: 1205987872
Entity Type: Individual
Name: DR. Michele Marie Revoir, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Jan 12, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 17565 CENTRAL AVE NE
City: Ham Lake
State: Minnesota
ZIP Code: 55304
Phone: (763) 434-4188

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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