Provider First Line Business Practice Location Address:
38745 N TIERRA SUBIDA
Provider Second Line Business Practice Location Address:
#150 SMILE CARE FAMILY DENTAL GROUP
Provider Business Practice Location Address City Name:
PALMDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-272-9091
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/09/2006