Provider First Line Business Practice Location Address:
646 SWIFT RD/BLDG 606, 1ST FLOOR
Provider Second Line Business Practice Location Address:
US ARMY DENTAL ACTIVITY
Provider Business Practice Location Address City Name:
WEST POINT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10996-1905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-938-4212
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/09/2013