Provider First Line Business Practice Location Address:
BLDG 45005 RUNION DENTAL CLINIC
Provider Second Line Business Practice Location Address:
USA DENTAC
Provider Business Practice Location Address City Name:
FT HUACHUCA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85670
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-533-3144
Provider Business Practice Location Address Fax Number:
520-533-7285
Provider Enumeration Date:
07/19/2006