Provider First Line Business Practice Location Address:
BLDG. E4110, AUSTIN ROAD
Provider Second Line Business Practice Location Address:
EDGEWOOD DENTAL CLINIC
Provider Business Practice Location Address City Name:
APG EDGEWOOD AREA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-436-3481
Provider Business Practice Location Address Fax Number:
410-436-2442
Provider Enumeration Date:
06/16/2006