Provider First Line Business Practice Location Address:
1425 PORTLAND AVENUE
Provider Second Line Business Practice Location Address:
DEPARTMENT OF DENTISTRY
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14621-3095
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-922-3844
Provider Business Practice Location Address Fax Number:
585-922-4495
Provider Enumeration Date:
05/30/2012