Provider First Line Business Practice Location Address:
MCRD DENTAL CLINIC 43000 MIDWAY AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DEIGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92140-5592
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-524-4009
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/20/2006