NPI 1023279254

Grigoriy Yusupov, DDS

Practitioner Dentist Elizabeth, NJ

Practice location

Address: 65 Jefferson Avenue, Elizabeth, NJ 07201
Phone: (908) 527-8688
Fax: (908) 527-9399

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 220102207500 (NJ)

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Registry record

NPI: 1023279254
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Jun 2008
Record last updated: 1 May 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.