Provider First Line Business Practice Location Address:
DEPT OF THE ARMY, DENTAL ACTIVITY STOP B
Provider Second Line Business Practice Location Address:
2817 REILLY RD, MCDS-NA-B
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:
910-396-5610
Provider Business Practice Location Address Fax Number:
910-396-7017
Provider Enumeration Date:
01/23/2006