Provider First Line Business Practice Location Address:
250 SQUIRE HALL
Provider Second Line Business Practice Location Address:
SCHOOL OF DENTAL MEDICINE UNIVERSITY AT BUFFALO
Provider Business Practice Location Address City Name:
BUFFALO, NY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14214-3008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-829-3845
Provider Business Practice Location Address Fax Number:
716-837-7823
Provider Enumeration Date:
07/31/2006