Provider First Line Business Practice Location Address:
9541 JOS CAMPALL
Provider Second Line Business Practice Location Address:
HAMTRAMCK DENTAL CENTER
Provider Business Practice Location Address City Name:
HAMTRACK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-972-4700
Provider Business Practice Location Address Fax Number:
313-972-1105
Provider Enumeration Date:
08/29/2006