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1073642823
REVAZ BERIDZE
FOREST HILLS, NY
NPI
1073642823
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: NY 046224-1)
Enumeration Date
2007-03-05
Last Update Date
2007-07-08
Business Address
-- REVAZ BERIDZE dds
10440 QUEENS BLVD #1Y
FOREST HILLS, NY 11375-3658
Phone number: 718-459-3159
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Mailing Address
-- REVAZ BERIDZE dds
10440 QUEENS BLVD #1Y
FOREST HILLS, NY 11375-3658
Phone number: 718-459-3159
Copy
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