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NPI Code Detail

MEDICARE: NAVAL DENTAL CLINIC OKINAWA

MEDICARE: NAVAL DENTAL CLINIC OKINAWA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1407039795
Entity Type Code : Organization
Provider Name (Legal Business Name) : NAVAL DENTAL CLINIC OKINAWA
Provider Business Mailing Address
First Line : PSC 482 BOX 1600
Second Line :
City : FPO
State : AP
Zip : 96362-0017
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : PSC 482 BOX 1600
Second Line :
City : FPO
State : AP
Zip : 96362-0017
Country : US
Telephone Number : 240-401-3643
Fax Number :
Authorized Official
Title or Position : NAVY MEDICINE UBO PROGRAM MANAGER
Name : MR. WILLIAM MICHAEL CONDON
Credential :
Telephone Number : 240-401-3643
Provider Enumeration Date : 12/10/2007
Last Update Date : 04/10/2018

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Directions to “NAVAL DENTAL CLINIC OKINAWA ” Practice Location

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