Gary L. Revercomb, DMD

General Practice Dentistry · Manlius, NY

Individual Active NPI

NPI number 1649371501

Practice location

8076 Cazenovia Rd
Manlius, NY 13104
Phone
(315) 682-8400
Fax
(315) 682-2602

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NPI record

NPI
1649371501
Entity type
Individual (Type 1)
Enumeration date
September 25, 2006
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 030581 NY

About Dr. Revercomb

Gary L. Revercomb, DMD is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 8076 Cazenovia Rd, Manlius, NY 13104. The NPI number 1649371501 was assigned on September 25, 2006 and the record was last updated on July 8, 2007.

Dr. Revercomb lists a license in the registry: #030581 (NY) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Gary L. Revercomb, DMD?

The NPI number is 1649371501.

What is the phone number of Dr. Revercomb?

The phone number listed for the practice location is (315) 682-8400.

Where is Dr. Revercomb located?

8076 Cazenovia Rd, Manlius, NY 13104.

What is the taxonomy code for Dr. Revercomb?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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