Provider First Line Business Practice Location Address:
BOAK DENTAL CLINIC
Provider Second Line Business Practice Location Address:
12720 KANSAS AVE BLDG 789
Provider Business Practice Location Address City Name:
FORT LEONARD WOOD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65473-6547
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-718-4719
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2018