| Dr Andrek Gv Ingersoll Dental Corporation | |
|
115 W Empire St Grass Valley CA 95945-7510 | |
| (530) 478-8366 | |
| Not Available |
| Full Name | Dr Andrek Gv Ingersoll Dental Corporation |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 115 W Empire St, Grass Valley, California |
| Authorized Official Name and Position | Andrek Ingersoll (OWNER) |
| Authorized Official Contact | 9196563004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Andrek Gv Ingersoll Dental Corporation 115 W Empire St Grass Valley CA 95945-7510 Ph: (530) 478-8366 | Dr Andrek Gv Ingersoll Dental Corporation 115 W Empire St Grass Valley CA 95945-7510 Ph: (530) 478-8366 |
| NPI Number | 1487488060 |
|---|---|
| Provider Enumeration Date | 08/27/2024 |
| Last Update Date | 08/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487488060 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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