# ALLCITY COSMETIC DENTAL CARE, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ALLCITY COSMETIC DENTAL CARE, PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1366673857
- **Legal business name:** ALLCITY COSMETIC DENTAL CARE, PC
- **Authorized official:** DR. BORIS YUSUPOV DDS (PRESIDENT)
- **Authorized official phone:** (631) 351-1222

## Contact information

- **Practice address:** 17 WALT WHITMAN RD, SUITE 5, HUNTINGTON STATION, NY 11746-3610
- **Practice address phone:** (631) 351-1222
- **Mailing address:** 17 WALT WHITMAN RD, SUITE 5, HUNTINGTON STATION, NY 11746-3610
- **Mailing address phone:** (631) 351-1222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 050130 | NY | Yes |

## Other

- **Enumeration date:** 07/31/2009
- **Last updated:** 07/31/2009