Revaz Beridze, DDS
NPI #1073642823 in Forest Hills, New York
Provider Information
- NPI Number
- 1073642823
- Entity Type
- Individual
- Name
- Revaz Beridze, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Mar 5, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 10440 QUEENS BLVD
- Address 2
- #1Y
- City
- Forest Hills
- State
- New York
- ZIP Code
- 11375-3658
- Phone
- (718) 459-3159
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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