National Provider Identifier Database

REVIVE DENTAL STUDIO LLC
General Practice

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.


Contact Information

REVIVE DENTAL STUDIO LLC
10 W HANOVER AVE STE 101
RANDOLPH, NJ07869-4221
Phone: 973-895-4333
Fax:
Website:
Specialty Taxonomy Code
* General Practice 1223G0001X

* Indicates primary specialty

NPI Profile & details for REVIVE DENTAL STUDIO LLC

NPI Number 1356071617
Legal business name
LBN
REVIVE DENTAL STUDIO LLC
Authorized official AZADEH DIANAT - (MANAGER)
Entity Organization
Organization subpart No
Enumeration date 06/10/2022
Last updated 06/10/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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