Provider First Line Business Practice Location Address:
618TH DENTAL COMPANY
Provider Second Line Business Practice Location Address:
UNIT #15659
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96218-0659
Provider Business Practice Location Address Country Code:
KR
Provider Business Practice Location Address Telephone Number:
01182534704307
Provider Business Practice Location Address Fax Number:
01182534705657
Provider Enumeration Date:
05/24/2006