Provider Demographics
NPI:1982912382
Name:DR SAMI A. YOUSUF, DDS, INC
Entity Type:Organization
Organization Name:DR SAMI A. YOUSUF, DDS, INC
Other - Org Name:NORWICH FAMILY & COSMETIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SAMI
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:860-887-2231
Mailing Address - Street 1:117 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2708
Mailing Address - Country:US
Mailing Address - Phone:860-887-2231
Mailing Address - Fax:860-892-1953
Practice Address - Street 1:117 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2708
Practice Address - Country:US
Practice Address - Phone:860-887-2231
Practice Address - Fax:860-892-1953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT84521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty