Organization
UNITED DENTAL ASSOCIATE P.C
Active
Other names
United Dental Associate P.C
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REVAZ BERIDZE DDS (PRESIDENT)
(718) 459-3159
Entity
Organization
Contact information
Practice address
10440 QUEENS BLVD STE 1Y, FOREST HILLS, NY 11375-3658
(718) 459-3159
Mailing address
10440 QUEENS BLVD STE 1Y, FOREST HILLS, NY 11375-3658
(718) 459-3159
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/01/2025
Last updated
07/01/2025
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