Provider First Line Business Practice Location Address:
PHV DENTAL CLINIC
Provider Second Line Business Practice Location Address:
CMR 442 BOX 103
Provider Business Practice Location Address City Name:
APO AE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
09081
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
174-206-7150
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2006