Provider First Line Business Practice Location Address:
CAMP SHELBY DENTAL CLINIC
Provider Second Line Business Practice Location Address:
BLDG 1450, 14TH STREET
Provider Business Practice Location Address City Name:
CAMP SHELBY
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-558-2575
Provider Business Practice Location Address Fax Number:
601-558-2235
Provider Enumeration Date:
04/18/2007