Provider First Line Business Practice Location Address:
VA MEDICAL CENTER DENTAL SERVICE 4500 S LANCASTER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75214-2636
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-742-8387
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/13/2005