Provider First Line Business Practice Location Address:
SMOKE BOMB HILL DENTAL CLINIC 3718 GRUBER RD RM 156A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT LIBERTY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28310-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-461-0867
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2023