Awadallah, Revana Emad
Awadallah, Revana Emad is an sole proprietor health care provider with primary practice located at 29663 Gateway Ave , Chisago City MN 55013-0339. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Awadallah, Revana Emad can be contacted via phone (651) 257-3639.Contact Information
Primary practice address
29663 Gateway Ave
Chisago City MN 55013-0339
Phone: (651) 257-3639
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D14808 | Minnesota |
Profile Details
| NPI number | 1972237089 |
|---|---|
| LBN Legal business name | Awadallah, Revana Emad |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 13th, 2022 |
| Last updated | Jul 13th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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