Provider First Line Business Practice Location Address:
351 W 6TH ST, BLDG 440
Provider Second Line Business Practice Location Address:
US ARMY DENTAL ACTIVITY
Provider Business Practice Location Address City Name:
FORT STEWART
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31314-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-767-6735
Provider Business Practice Location Address Fax Number:
520-533-7285
Provider Enumeration Date:
05/22/2006