Provider Demographics
NPI:1124908389
Name:MILTON REVELO DENTAL LLC
Entity type:Organization
Organization Name:MILTON REVELO DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:CESAR
Authorized Official - Last Name:REVELO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-346-9383
Mailing Address - Street 1:54 S MAISH RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IN
Mailing Address - Zip Code:46041-2824
Mailing Address - Country:US
Mailing Address - Phone:407-346-9383
Mailing Address - Fax:
Practice Address - Street 1:54 S MAISH RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IN
Practice Address - Zip Code:46041-2824
Practice Address - Country:US
Practice Address - Phone:407-346-9383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-06
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty