Provider First Line Business Practice Location Address:
220 13TH ST
Provider Second Line Business Practice Location Address:
DENTAL DEPARTMENT
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11215-4802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-832-5980
Provider Business Practice Location Address Fax Number:
718-832-5991
Provider Enumeration Date:
09/20/2006