Provider First Line Business Practice Location Address:
VA MEDICAL CENTER, DENTAL CLINIC
Provider Second Line Business Practice Location Address:
400 VETERANS AVE
Provider Business Practice Location Address City Name:
BILOXI
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
228-523-5103
Provider Business Practice Location Address Fax Number:
228-523-4910
Provider Enumeration Date:
06/20/2006