Provider First Line Business Practice Location Address:
1 JARRETT WHITE RD BLDG 320
Provider Second Line Business Practice Location Address:
USA DENTAC HAWAII
Provider Business Practice Location Address City Name:
TRIPLER AMC
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96859-5001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-751-6213
Provider Business Practice Location Address Fax Number:
803-751-6886
Provider Enumeration Date:
08/17/2011