Provider First Line Business Practice Location Address:
620 PAUL JONES CIRCLE
Provider Second Line Business Practice Location Address:
NAVAL MEDICAL CENTER: ORAL SURGERY RESIDENT ROOM
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23708-2370
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-322-0159
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/05/2019