Provider First Line Business Practice Location Address:
2601 OCEAN PKWY
Provider Second Line Business Practice Location Address:
DENTAL DEPARTMENT, ROOM 3N3
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-786-3041
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/06/2021