Provider First Line Business Practice Location Address:
USA DENTAC FORT CAVAZOS
Provider Second Line Business Practice Location Address:
36000 SHOEMAKER LANE SUITE 1051
Provider Business Practice Location Address City Name:
FORT CAVAZOS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76544-1529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
542-867-4022
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/29/2006