Provider First Line Business Practice Location Address:
800 ZORN AVE
Provider Second Line Business Practice Location Address:
VAMC DENTAL SERVICE
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40206-1433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-287-5352
Provider Business Practice Location Address Fax Number:
502-287-6174
Provider Enumeration Date:
10/05/2006