Individual
DR. BRENT THOMAS INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5149 MOORPARK AVE, # 101, SAN JOSE, CA 95129
(408) 996-9393
(408) 996-3034
Mailing address
5149 MOORPARK AVE, # 101, SAN JOSE, CA 95129
(408) 996-9393
(408) 996-3034
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
CA43978
CA
Other
Enumeration date
11/03/2006
Last updated
07/08/2007
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