Individual
DENNIS ALAN INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
STATE LICENSED OPTIC
Contact information
Practice address
1317 JOSHUA AVE, SUITE H, PARKER, AZ 85344
(928) 669-6971
(928) 669-8901
Mailing address
828 CRYSTAL VIEW DR, PARKER, AZ 85344
(928) 667-3153
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1140
AZ
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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