Provider First Line Business Practice Location Address:
210A SQUIRE HALL
Provider Second Line Business Practice Location Address:
SCHOOL OF DENTAL MEDICINE UNIVERSITY AT BUFFALO SUNY
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14214-8006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-829-2721
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/22/2006