Provider First Line Business Practice Location Address:
1849 86TH STREET
Provider Second Line Business Practice Location Address:
INTERMED DENTAL SYSTEMS PC
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11214-3108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-256-0800
Provider Business Practice Location Address Fax Number:
718-621-6444
Provider Enumeration Date:
08/24/2006