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1972237089
REVANA EMAD AWADALLAH
CHISAGO CITY, MN
NPI
1972237089
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: MN D14808)
Enumeration Date
2022-07-13
Last Update Date
2022-07-13
Business Address
Dr. REVANA EMAD AWADALLAH DMD
29663 GATEWAY AVE
CHISAGO CITY, MN 55013-0339
Phone number: 651-257-3639
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Mailing Address
Dr. REVANA EMAD AWADALLAH DMD
7741 WINTER WHEAT WAY
WOODBURY, MN 55129-2401
Phone number: 651-274-7561
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