Provider First Line Business Practice Location Address:
1001 RIO VISTA DR.
Provider Second Line Business Practice Location Address:
C/O FTHC - DENTAL
Provider Business Practice Location Address City Name:
FALLON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-423-3634
Provider Business Practice Location Address Fax Number:
775-423-4342
Provider Enumeration Date:
10/20/2010