Provider First Line Business Practice Location Address:
115 CHRISTOPHER COLUMBUS DR
Provider Second Line Business Practice Location Address:
DEPARTMENT OF DENTISTRY
Provider Business Practice Location Address City Name:
JERSEY CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07302-5526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-369-3228
Provider Business Practice Location Address Fax Number:
201-770-3750
Provider Enumeration Date:
02/03/2010