Provider First Line Business Practice Location Address:
BLDG. 312 CHRISMAN ST
Provider Second Line Business Practice Location Address:
FT. BUCHANAN DENTAL CLINIC
Provider Business Practice Location Address City Name:
FT. BUCHANAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00934-5066
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-707-2040
Provider Business Practice Location Address Fax Number:
787-707-3494
Provider Enumeration Date:
08/03/2005