Provider First Line Business Practice Location Address:
760 BROADWAY, ROOM 2C319
Provider Second Line Business Practice Location Address:
DEPARTMENT OF DENTISTRY/ATTENTION M.RODRIGUEZ
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-963-8310
Provider Business Practice Location Address Fax Number:
718-630-3244
Provider Enumeration Date:
11/20/2019