| Ingersoll Knollcrest Os Dental Corporation | |
|
316 Knollcrest Dr Redding CA 96002-0104 | |
| (919) 656-3004 | |
| Not Available |
| Full Name | Ingersoll Knollcrest Os Dental Corporation |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 316 Knollcrest Dr, Redding, California |
| Authorized Official Name and Position | Andrek Jeffrey Ingersoll (MANAGER) |
| Authorized Official Contact | 9196563004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ingersoll Knollcrest Os Dental Corporation 3300 N Triumph Blvd Ste 100 Lehi UT 84043-5046 Ph: (801) 494-4949 | Ingersoll Knollcrest Os Dental Corporation 316 Knollcrest Dr Redding CA 96002-0104 Ph: (919) 656-3004 |
| NPI Number | 1215537444 |
|---|---|
| Provider Enumeration Date | 10/27/2020 |
| Last Update Date | 10/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215537444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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