Provider First Line Business Practice Location Address:
STONY BROOK UNIVERSITY SCHOOL OF
Provider Second Line Business Practice Location Address:
SULLIVAN HALL-DENTAL CARE CENTER
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-8700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-632-8974
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2009