Provider First Line Business Practice Location Address:
423 EAST 23RD ST.
Provider Second Line Business Practice Location Address:
MANHATTAN V.A., DENTAL DEPT.
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-951-3255
Provider Business Practice Location Address Fax Number:
212-951-3378
Provider Enumeration Date:
02/13/2007