Provider First Line Business Practice Location Address:
400 WEST CRAWFORD AVENUE, SUITE C
Provider Second Line Business Practice Location Address:
MONTERY DENTAL CENTER
Provider Business Practice Location Address City Name:
MONTEREY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
931-839-8684
Provider Business Practice Location Address Fax Number:
931-839-3299
Provider Enumeration Date:
12/24/2007