Provider Demographics
NPI:1801963186
Name:FAMILY & COSMETIC DENTISTRY
Entity type:Organization
Organization Name:FAMILY & COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAVEED
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-333-1516
Mailing Address - Street 1:1960 MENDON ROAD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-4318
Mailing Address - Country:US
Mailing Address - Phone:401-333-1516
Mailing Address - Fax:401-333-4536
Practice Address - Street 1:1960 MENDON ROAD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-4318
Practice Address - Country:US
Practice Address - Phone:401-333-1516
Practice Address - Fax:401-333-4536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN02474122300000X
RIDEN02472122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty