Individual
RENEE CASSIDY INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
701 PARK AVE SOUTH, MINNEAPOLIST, MN 55415
(612) 873-3000
Mailing address
715 SOUTH 8TH STREET, SUITE 4, MINNEAPOLIS, MN 55404
(612) 873-3000
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/01/2024
Last updated
07/10/2024
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