Provider First Line Business Practice Location Address:
472 BOSTON POST RD SUITE 5
Provider Second Line Business Practice Location Address:
ORANGE DENTAL GROUP
Provider Business Practice Location Address City Name:
ORANGE
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-295-0330
Provider Business Practice Location Address Fax Number:
203-795-6634
Provider Enumeration Date:
02/12/2007