Provider First Line Business Practice Location Address:
HQS, USA DENTAC
Provider Second Line Business Practice Location Address:
2410 STANLEY ROAD
Provider Business Practice Location Address City Name:
FT SAM HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78234-6200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-295-2743
Provider Business Practice Location Address Fax Number:
210-295-2602
Provider Enumeration Date:
02/02/2006