Provider First Line Business Practice Location Address:
15 CANAL RD.
Provider Second Line Business Practice Location Address:
DENTSERV
Provider Business Practice Location Address City Name:
PELHAM MANOR
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10803-9905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-738-1144
Provider Business Practice Location Address Fax Number:
914-738-0331
Provider Enumeration Date:
01/23/2009