Provider First Line Business Practice Location Address:
1941 FRONT STREET
Provider Second Line Business Practice Location Address:
FRONT STREET DENTAL SERVICES PC
Provider Business Practice Location Address City Name:
EAST MEADOW
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-794-0050
Provider Business Practice Location Address Fax Number:
516-794-4577
Provider Enumeration Date:
02/27/2007