Provider First Line Business Practice Location Address:
LINCOLN ST 2ND FLOOR, BLDG 9900
Provider Second Line Business Practice Location Address:
USA DENTAC
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-968-4039
Provider Business Practice Location Address Fax Number:
253-968-4039
Provider Enumeration Date:
01/06/2006