Provider First Line Business Practice Location Address:
USA DENTAC
Provider Second Line Business Practice Location Address:
B 2817 REILLY ROAD
Provider Business Practice Location Address City Name:
FORT BRAGG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28310-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-787-6927
Provider Business Practice Location Address Fax Number:
706-787-2082
Provider Enumeration Date:
12/13/2005