| Ingram And Daugherty Orthodontists, Llc | |
|
710 S 12th St Lebanon PA 17042-6901 | |
| (717) 274-2913 | |
| Not Available |
| Full Name | Ingram And Daugherty Orthodontists, Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 710 S 12th St, Lebanon, Pennsylvania |
| Authorized Official Name and Position | Stephen B Ingram (ORTHODONTIST) |
| Authorized Official Contact | 7172742913 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ingram And Daugherty Orthodontists, Llc 710 S 12th St Lebanon PA 17042-6901 Ph: (717) 274-2913 | Ingram And Daugherty Orthodontists, Llc 710 S 12th St Lebanon PA 17042-6901 Ph: (717) 274-2913 |
| NPI Number | 1396870317 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396870317 | NPI | - | NPPES |
| DS020047L | Other | PA | DR INGRAMS STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DS020047L (Pennsylvania) | Primary |
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