Provider First Line Business Practice Location Address:
741 SECAUCUS RD
Provider Second Line Business Practice Location Address:
EASTCOAST FAMILY DENTISTRY
Provider Business Practice Location Address City Name:
JERSEY CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07307-2565
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-963-7898
Provider Business Practice Location Address Fax Number:
201-963-8781
Provider Enumeration Date:
01/02/2009