Most Relevant Information
Provider Data
| NPI Number: | 1003309279 |
| Provider Name: | GABIJA REVIS DMD |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | DN1858579 |
Most Important Dates
| Enumeration Date: | 06/12/2018 |
| Last Updated: | 08/08/2022 |
Provider Practice Location
4201 RUCKER AVE
EVERETT
WA
982032215
Practice Location Phone/Fax
| Phone: | 4253824000 |
| Fax: |
Provider Mailing Location
755 WORTHINGTON ST
SPRINGFIELD
MA
011051140
Provider Mailing Phone/Fax
| Phone: | 4137319575 |
| Fax: |