Provider First Line Business Practice Location Address:
220-24 HILLSIDE AVE
Provider Second Line Business Practice Location Address:
PRUDENTCARE DENTAL SERVICES
Provider Business Practice Location Address City Name:
QUEENS VILLAGE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-479-7100
Provider Business Practice Location Address Fax Number:
718-479-1556
Provider Enumeration Date:
05/29/2008