Provider First Line Business Practice Location Address:
2350 ATASCOCITA RD
Provider Second Line Business Practice Location Address:
LYCHNER UNIT, DENTAL DEPARTMENT
Provider Business Practice Location Address City Name:
HUMBLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77396-3503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-454-5036
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2007