Provider First Line Business Practice Location Address:
3300 S. UNIVERSITY DRIVE
Provider Second Line Business Practice Location Address:
NSU FLORIDA, DEPT. OF ORAL & MAXILLOFACIAL SURGERY
Provider Business Practice Location Address City Name:
FORT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33328-2004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-262-7332
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/19/2011