Provider First Line Business Practice Location Address:
38717 38TH STREET
Provider Second Line Business Practice Location Address:
US ARMY DENTAL HEALTH ACTIVITY
Provider Business Practice Location Address City Name:
FT. GORDON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-787-6927
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2014