Provider First Line Business Practice Location Address:
1700 S. LINCOLN AVENUE
Provider Second Line Business Practice Location Address:
VAMC DENTAL SERVICE N340
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-272-6621
Provider Business Practice Location Address Fax Number:
717-228-6115
Provider Enumeration Date:
09/22/2006