Revital Dental Pllc

LBN: Revital Dental Pllc
Revital Dental Pllc is an health care organization with primary practice located at 4311 S 31St St Ste 145 , Temple TX 76502-3346. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Ambulatory Health Care Facilities / Dental. Dental Providers / General Practice is the primary health care specialty. Revital Dental Pllc can be contacted via phone (347) 631-0848, or through Kondragunta, Suman Kishore via phone (347) 631-0848.

Contact Information

Primary practice address
4311 S 31St St Ste 145 Temple TX 76502-3346
Phone: (347) 631-0848
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kondragunta, Suman Kishore Doctor of Dental Surgery (DDS)
Phone: (347) 631-0848

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X
Ambulatory Health Care Facilities / Dental 261QD0000X

Profile Details

NPI number 1437899812
LBN Legal business name Revital Dental Pllc
DBA Doing business as
Authorized official Kondragunta, Suman Kishore Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 1st, 2022
Last updated Sep 14th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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