Provider First Line Business Practice Location Address:
CDR US ARMY DENTAL ACTIVITY
Provider Second Line Business Practice Location Address:
CMR 489 BOX 2604
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-371-2288
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2006