Individual
DR. GEORGE GOTSIRIDZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12919 ALTON SQ APT #209, HERNDON, VA 20170
(781) 249-2087
Mailing address
12919 ALTON SQ APT #209, HERNDON, VA 20170
(781) 249-2087
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401413621
VA
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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