Provider First Line Business Practice Location Address:
UMDNJ-NEW JERSEY DENTAL SCHOOL
Provider Second Line Business Practice Location Address:
110 BERGEN STREET, D830
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-972-3851
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2007