Provider First Line Business Practice Location Address:
1605 COUNTY ROAD 220 STE 110
Provider Second Line Business Practice Location Address:
ATTN DR. WEBER--ORTHODONTICS
Provider Business Practice Location Address City Name:
FLEMING ISLAND
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32003-4909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-215-3533
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/08/2006