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Organization
UNITED STATES AIR FORCE
Active
Organization
UNITED STATES AIR FORCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN HAMILTON (AEGD DIRECTOR)
(707) 423-7008
Entity
Organization
Contact information
Practice address
101 BODIN CIR, FAIRFIELD, CA 94535-1809
(707) 423-7008
Mailing address
101 BODIN CIR, FAIRFIELD, CA 94535-1809
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019030225
IL
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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