Provider First Line Business Practice Location Address:
USS MAKIN ISLAND LHD8
Provider Second Line Business Practice Location Address:
DENTAL DEPARTMENT, UNIT 100222
Provider Business Practice Location Address City Name:
FPO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96672-1601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-545-8486
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/17/2012