Provider First Line Business Practice Location Address:
618TH DENTAL COMPANY (AS),
Provider Second Line Business Practice Location Address:
USA DENTAC-KOREA UNIT #15660 BLDG # P 3020
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96271-5660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-737-9186
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2018