Provider First Line Business Practice Location Address:
345 E 24TH ST
Provider Second Line Business Practice Location Address:
ATTN: PEDIATRIC DENTISTRY DEPT.
Provider Business Practice Location Address City Name:
NYC
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10010-4020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-998-9657
Provider Business Practice Location Address Fax Number:
212-995-4242
Provider Enumeration Date:
01/03/2006