Provider First Line Business Practice Location Address:
MONTEFIORE MEDICAL CENTER DEPT. OF DENTISTRY
Provider Second Line Business Practice Location Address:
1575 BLONDELL AVE. SUITE 150
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-405-8190
Provider Business Practice Location Address Fax Number:
718-405-8198
Provider Enumeration Date:
10/26/2005