Revive Periodontics and Implants
NPI #1619722857 in Burnsville, Minnesota
Provider Information
- NPI Number
- 1619722857
- Entity Type
- Organization
- Organization Name
- Revive Periodontics and Implants
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Apr 22, 2024
- Last Updated
- Apr 22, 2024
Practice Location
- Address
- 625 E NICOLLET BLVD STE 330
- City
- Burnsville
- State
- Minnesota
- ZIP Code
- 55337-6736
- Phone
- (952) 435-0333
Authorized Official
- Name
- DR. ANDREW GLOVER, DDS
- Title
- PRESIDENT
- Phone
- (651) 334-2190
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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