Provider First Line Business Practice Location Address:
CODE J-1001 BUILDING 277
Provider Second Line Business Practice Location Address:
NORFOLK NAVAL SHIPYARD BRANCH DENTAL CLINIC
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23709-1001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-953-6509
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/30/2016