Provider Demographics
NPI:1508543232
Name:MY DENTAL STUDIO PLLC
Entity Type:Organization
Organization Name:MY DENTAL STUDIO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-340-4008
Mailing Address - Street 1:241 KING ST STE 220
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2344
Mailing Address - Country:US
Mailing Address - Phone:413-586-4200
Mailing Address - Fax:
Practice Address - Street 1:241 KING ST STE 220
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2344
Practice Address - Country:US
Practice Address - Phone:413-586-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-04
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty