Provider First Line Business Practice Location Address:
UNITED STATES MILITYARY ACADEMY
Provider Second Line Business Practice Location Address:
DENTAC, 646 SWIFT ROAD
Provider Business Practice Location Address City Name:
WEST POINT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10996-1905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-938-4212
Provider Business Practice Location Address Fax Number:
845-938-4302
Provider Enumeration Date:
10/12/2006