Provider First Line Business Practice Location Address:
1ST ADVANTAGE DENTAL
Provider Second Line Business Practice Location Address:
1092 ROUTE 9
Provider Business Practice Location Address City Name:
QUEENSBURY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12804-0382
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-798-9561
Provider Business Practice Location Address Fax Number:
518-798-6205
Provider Enumeration Date:
09/23/2011