Provider First Line Business Practice Location Address:
356 W 18TH STREET
Provider Second Line Business Practice Location Address:
CALLEN-LORDE CHC, DEPT OF DENTISTRY
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-271-7171
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/12/2007