Provider First Line Business Practice Location Address:
625 ELMWOOD AVE
Provider Second Line Business Practice Location Address:
EASTMAN DENTAL CENTER
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14620-2989
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-275-5043
Provider Business Practice Location Address Fax Number:
585-244-8772
Provider Enumeration Date:
09/05/2006