Provider First Line Business Practice Location Address:
1997 OCEAN AVE
Provider Second Line Business Practice Location Address:
MODERN DENTISTRY
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11230-7385
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-339-6000
Provider Business Practice Location Address Fax Number:
718-339-3187
Provider Enumeration Date:
02/03/2012