Provider First Line Business Practice Location Address:
USA DENTAL ACTIVITY - FORT MOORE
Provider Second Line Business Practice Location Address:
7061 LINCOLN AVENUE, BUILDING 972
Provider Business Practice Location Address City Name:
FORT MOORE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-544-3103
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/09/2014