Provider First Line Business Practice Location Address:
BLDG 4100 GOSS RD
Provider Second Line Business Practice Location Address:
REDSTAONE ARSENAL DENTAL CLINIC
Provider Business Practice Location Address City Name:
REDSTONE ARSENAL
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35809-7000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-693-7127
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2005