| NPI | 1922838432 |
|---|---|
| Doing Business As | GOLD COAST ORAL AND MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | STEVE YUSUPOV Owner 516-749-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-08-07 |