Provider First Line Business Practice Location Address:
LANDSTUHL DENTAL ACTIVITY CREDENTIALS OFFICE
Provider Second Line Business Practice Location Address:
CMR 402
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09180
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
011496371929130
Provider Business Practice Location Address Fax Number:
011496371929117
Provider Enumeration Date:
08/06/2009