Provider First Line Business Practice Location Address:
611 NORTHERN BLVD
Provider Second Line Business Practice Location Address:
GREAT NECK DENTAL ASSOCIATES
Provider Business Practice Location Address City Name:
GREAT NECK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11021-5201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-487-5500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/30/2007