Organization
ALLCITY COSMETIC DENTAL CARE, PC
Active
Parent organization
ALLCITY COSMETIC DENTAL CARE, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALLCITY COSMETIC DENTAL CARE, PC
Authorized official
DR. BORIS YUSUPOV DDS (PRESIDENT)
(631) 351-1222
Entity
Organization
Contact information
Practice address
17 WALT WHITMAN RD, SUITE 5, HUNTINGTON STATION, NY 11746-3610
(631) 351-1222
Mailing address
17 WALT WHITMAN RD, SUITE 5, HUNTINGTON STATION, NY 11746-3610
(631) 351-1222
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
050130
NY
Other
Enumeration date
07/31/2009
Last updated
07/31/2009
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