Provider First Line Business Practice Location Address:
DENTAL CLINIC 3
Provider Second Line Business Practice Location Address:
2954 CARRINGTON RD
Provider Business Practice Location Address City Name:
FORT BLISS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-742-2685
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/27/2012