Individual
DR. GABIJA REVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4201 RUCKER AVE, EVERETT, WA 98203-2215
(425) 382-4000
Mailing address
755 WORTHINGTON ST, SPRINGFIELD, MA 01105-1140
(413) 731-9575
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN1858579
MA
1223G0001X
General Practice Dentistry
00203586
CO
1223G0001X
General Practice Dentistry
Primary
DE61301658
WA
Other
Enumeration date
06/12/2018
Last updated
08/08/2022
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