Provider First Line Business Practice Location Address:
412 ST RT 37
Provider Second Line Business Practice Location Address:
SAINT REGIS MOHAWK HEALTH SERVICES DENTAL
Provider Business Practice Location Address City Name:
AKWESASNE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13655-2277
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-358-3141
Provider Business Practice Location Address Fax Number:
518-358-2797
Provider Enumeration Date:
11/18/2005