Yuriy Yusupov, D.D.S., M.D.
Dentist, Oral and Maxillofacial Surgery in Brooklyn, NY. Individual provider (NPI-1).
NPI number1760637672
StatusActive
Last updated in NPPESOct 10, 2011
Details
- NPI
- 1760637672
- Entity type
- Individual (NPI-1)
- Name
- Yuriy Yusupov
- Credential
- D.D.S., M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 19, 2008
- Last updated
- Oct 10, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 052623 | NY | Yes |
Practice location
7901 4th Ave Ste A3Brooklyn, NY 11209-3970
Phone 718-745-0400
Mailing address
7901 4th Ave Ste A3Brooklyn, NY 11209-3970
Phone 718-745-0400
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