Provider First Line Business Practice Location Address:
NAVAL HEALTH CLINIC JOINT RESERVE BASE
Provider Second Line Business Practice Location Address:
DENTAL DEPARTMENT BLDG 137
Provider Business Practice Location Address City Name:
WILLOW GROVE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-443-6380
Provider Business Practice Location Address Fax Number:
215-443-6378
Provider Enumeration Date:
08/19/2006