Ingersoll Park Marina Gp Dental Corporation | |
2301 Park Marina Dr Ste 27 Redding CA 96001-2158 | |
(801) 494-4949 | |
Not Available |
Full Name | Ingersoll Park Marina Gp Dental Corporation |
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Speciality | Clinic/center - Dental |
Location | 2301 Park Marina Dr Ste 27, 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 |
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Ingersoll Park Marina Gp Dental Corporation 3300 N Triumph Blvd Ste 100 Lehi UT 84043-5046 Ph: (801) 494-4949 | Ingersoll Park Marina Gp Dental Corporation 2301 Park Marina Dr Ste 27 Redding CA 96001-2158 Ph: (801) 494-4949 |
NPI Number | 1316547524 |
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Provider Enumeration Date | 10/27/2020 |
Last Update Date | 10/27/2020 |
Identifier | Type | State | Issuer |
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1316547524 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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