Revana Awadallah, DMD

NPI 1972237089 · on the registry since 2022 · sole proprietor

Practice

Address: 29663 Gateway Ave
Chisago City, MN 55013
Phone: (651) 257-3639
Organisation at this address: Modern Dental Professionals Minnesota Pc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 1223G0001X
1223G0001X
Licence states on file: MN
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2022-07-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota