Provider First Line Business Practice Location Address:
1364 CONEY ISLAND AVE
Provider Second Line Business Practice Location Address:
MIDWOOD DENTAL CENTER 2ND FLOOR
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-252-9222
Provider Business Practice Location Address Fax Number:
718-252-0982
Provider Enumeration Date:
08/08/2006