Provider First Line Business Practice Location Address:
US ARMY DENTAL ACTIVITY
Provider Second Line Business Practice Location Address:
BLDG M4861 LOGISTICS AVE/ JOEL DENTAL CLINIC
Provider Business Practice Location Address City Name:
FORT BRAGG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28310-7302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-643-2196
Provider Business Practice Location Address Fax Number:
910-907-7904
Provider Enumeration Date:
07/28/2014