Individual
MRS. JACQUELINE A INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
244 COLLEGE AVE, BEAVER, PA 15009-2706
(724) 774-1361
(724) 774-1932
Mailing address
244 COLLEGE AVE, BEAVER, PA 15009-2706
(724) 774-1361
(724) 774-1932
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/13/2009
Last updated
03/13/2009
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