# UNITED DENTAL ASSOCIATE P.C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** United Dental Associate P.C
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225927494
- **Authorized official:** DR. REVAZ BERIDZE DDS (PRESIDENT)
- **Authorized official phone:** (718) 459-3159

## Contact information

- **Practice address:** 10440 QUEENS BLVD STE 1Y, FOREST HILLS, NY 11375-3658
- **Practice address phone:** (718) 459-3159
- **Mailing address:** 10440 QUEENS BLVD STE 1Y, FOREST HILLS, NY 11375-3658
- **Mailing address phone:** (718) 459-3159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/01/2025
- **Last updated:** 07/01/2025