Provider First Line Business Practice Location Address:
2515 HWY 516
Provider Second Line Business Practice Location Address:
UNIT 2A EMPIRE DENTAL PC
Provider Business Practice Location Address City Name:
OLD BRIDGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08857
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-607-0909
Provider Business Practice Location Address Fax Number:
732-607-7555
Provider Enumeration Date:
08/19/2006