Provider First Line Business Practice Location Address:
7101 HOFF ST BLDG 9240
Provider Second Line Business Practice Location Address:
USA DENTAL ACTIVITY
Provider Business Practice Location Address City Name:
FORT BENNING
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31905-5645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-544-4530
Provider Business Practice Location Address Fax Number:
706-544-1933
Provider Enumeration Date:
10/24/2013