# ANDREK PMENDO INGERSOLL DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942098934
- **Authorized official:** MRS. LEEANN BLAZER (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (707) 673-7531

## Contact information

- **Practice address:** 2301 PARK MARINA DR STE 23, REDDING, CA 96001-2158
- **Practice address phone:** (530) 697-0110
- **Mailing address:** 3300 N TRIUMPH BLVD STE 100, LEHI, UT 84043-5046
- **Mailing address phone:** (707) 673-7531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | — | Yes |

## Other

- **Enumeration date:** 04/29/2025
- **Last updated:** 04/29/2025