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Organization
SEVILLE PARK ENDODONTICS PLLC
Active
Organization
SEVILLE PARK ENDODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY A INGRAM DMD MS (ENDODONTIST)
(210) 617-8536
Entity
Organization
Contact information
Practice address
8211 FREDERICKSBURG RD, SAN ANTONIO, TX 78229
(210) 617-5536
(210) 614-4266
Mailing address
8211 FREDERICKSBURG RD, SAN ANTONIO, TX 78229
(210) 617-5536
(210) 614-4266
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
17400
TX
1223E0200X
Endodontics
18608
TX
Other
Enumeration date
10/05/2006
Last updated
08/22/2020
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