Provider First Line Business Practice Location Address:
263 FARMINGTON AVE
Provider Second Line Business Practice Location Address:
UCONN SCHOOL OF DENTAL MEDICINE
Provider Business Practice Location Address City Name:
FARMINGTON
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06030-3905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-679-4081
Provider Business Practice Location Address Fax Number:
860-679-4078
Provider Enumeration Date:
12/26/2006