Provider First Line Business Practice Location Address:
1175 HART ST.
Provider Second Line Business Practice Location Address:
MCAS YUMA BRANCH DENTAL CLINIC
Provider Business Practice Location Address City Name:
YUMA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85369
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-269-2353
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/15/2005