Organization
GOLD COAST ORAL & MAXILLOFACIAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE YUSUPOV DDS, MD (OWNER)
(718) 593-5814
Entity
Organization
Contact information
Practice address
55 BRYANT AVE, ROSLYN, NY 11576-1139
(516) 749-3000
Mailing address
55 BRYANT AVE, ROSLYN, NY 11576-1139
(516) 749-3000
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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