Provider First Line Business Practice Location Address:
184 SULLIVAN HALL
Provider Second Line Business Practice Location Address:
STONY BROOK UNIVERSITY SCHOOL OF DENTAL MEDICINE
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-8705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-632-8975
Provider Business Practice Location Address Fax Number:
631-632-3747
Provider Enumeration Date:
08/28/2008