Provider First Line Business Practice Location Address:
FAIRBANK DENTAL CLINIC #5
Provider Second Line Business Practice Location Address:
BATTALION AVENUE BLDG 9440
Provider Business Practice Location Address City Name:
FORT HOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76544
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-288-7848
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/19/2021