Organization
DENTAL OFFICE OF ANDREK J INGERSOLL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEEANN BLAZER (DIRECTOR OF OPERATIONS)
(707) 673-7531
Entity
Organization
Contact information
Practice address
585 TAHOE KEYS BLVD STE 2, SOUTH LAKE TAHOE, CA 96150-3371
(530) 541-3772
Mailing address
585 TAHOE KEYS BLVD STE 2, SOUTH LAKE TAHOE, CA 96150-3371
(530) 541-3772
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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