Provider First Line Business Practice Location Address:
STONY BROOK DENTAL ASSOCIATES INC
Provider Second Line Business Practice Location Address:
SULLIVAN HALL - ROOM 170 - FACULTY PRACTICE
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-8705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-632-8971
Provider Business Practice Location Address Fax Number:
631-632-7658
Provider Enumeration Date:
12/18/2007