Provider First Line Business Practice Location Address:
3304 GLENWOOD
Provider Second Line Business Practice Location Address:
PRISM DENTAL PC
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-434-3900
Provider Business Practice Location Address Fax Number:
718-434-4603
Provider Enumeration Date:
07/05/2013