| NPI | 1578251930 |
|---|---|
| Doing Business As | REVIVE COSMETIC DENTISTRY PLLC |
| Entity Type | Organization |
| Authorized Contact | MALAIKA S. THOMAS CEO 469-914-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2024-01-05 |