Provider First Line Business Practice Location Address:
1 GUSTAVE LEVY PLACE
Provider Second Line Business Practice Location Address:
DENTAL DEPARTMENT, MOUNT SINAI SCHOOL OF MEDICINE
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-241-9619
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/08/2009