Organization
GOLD COAST ORAL AND MAXILLOFACIAL SURGERY SYOSSET PLLC
Active
Other names
Gold Coast Oral and Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVE YUSUPOV DDS, MD (OWNER)
(516) 749-3000
Entity
Organization
Contact information
Practice address
40 UNDERHILL BLVD, SYOSSET, NY 11791-3490
(516) 744-6262
(516) 744-6262
Mailing address
55 BRYANT AVE, SUITE 2, ROSLYN, NY 11576
(516) 749-3000
(516) 749-3000
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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