Provider First Line Business Practice Location Address:
618 DENTAL CO/US ARMY DENTAC-KOREA
Provider Second Line Business Practice Location Address:
UNIT 15652 ATTN: CREDENTIALS OFFICE
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96271
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-968-4029
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/13/2021