| NPI | 1114100062 |
|---|---|
| Doing Business As | BAY SHORE FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | KOUROSH YAGHOUBIAN V.P. 631-968-5995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2007-12-14 |