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NPI Code Detail

MEDICARE: BRANCH DENTAL CLINIC CAMP COURTNEY

MEDICARE: BRANCH DENTAL CLINIC CAMP COURTNEY
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 : 1962608935
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRANCH DENTAL CLINIC CAMP COURTNEY
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 : BUMED UBO
Name : WILLIAM M CONDON
Credential :
Telephone Number : 240-401-3643
Provider Enumeration Date : 06/26/2007
Last Update Date : 04/10/2018

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Directions to “BRANCH DENTAL CLINIC CAMP COURTNEY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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