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1023279254
GRIGORIY YUSUPOV
ELIZABETH, NJ
NPI
1023279254
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: NJ 220102207500)
Enumeration Date
2008-06-20
Last Update Date
2012-05-01
Business Address
Dr. GRIGORIY YUSUPOV DDS
65 JEFFERSON AVENUE
ELIZABETH, NJ 07201
Phone number: 908-527-8688
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Mailing Address
Dr. GRIGORIY YUSUPOV DDS
65 JEFFERSON AVENUE
ELIZABETH, NJ 07201
Phone number: 908-527-8688
Copy
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