Provider First Line Business Practice Location Address:
PARK AVENUE PERIODONTAL ASSOCIATES
Provider Second Line Business Practice Location Address:
532 PARK AVENUE
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-838-0940
Provider Business Practice Location Address Fax Number:
212-355-4784
Provider Enumeration Date:
05/11/2007