Provider First Line Business Practice Location Address:
AVE-R 1310 EMMANUIL TEPER DENTAL PC
Provider Second Line Business Practice Location Address:
SUITE 1-D
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11229-2853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-336-2484
Provider Business Practice Location Address Fax Number:
718-336-2367
Provider Enumeration Date:
01/10/2007