Provider First Line Business Practice Location Address:
2027 3RD AVE
Provider Second Line Business Practice Location Address:
DENTAL STOREFRONT
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:
212-996-0900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/18/2018