Provider First Line Business Practice Location Address:
US ARMY DENTAL HEALTH ACTIVITY
Provider Second Line Business Practice Location Address:
520 POPE AVENUE
Provider Business Practice Location Address City Name:
FORT LEAVENWORTH
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-684-5516
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/11/2007