Provider First Line Business Practice Location Address:
114 W 71ST ST
Provider Second Line Business Practice Location Address:
COSMETIC DENTISTRY OF NEW YORK
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10023-4041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-721-4549
Provider Business Practice Location Address Fax Number:
212-501-7452
Provider Enumeration Date:
09/14/2011