Provider First Line Business Practice Location Address:
221 AVENUE B
Provider Second Line Business Practice Location Address:
GROUND FLOOR DENTAL OFFICE
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-960-9979
Provider Business Practice Location Address Fax Number:
646-960-9979
Provider Enumeration Date:
04/16/2007