Individual
RACHEL SNOW INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2727 N OAKLAND AVE, SUITE 102, DECATUR, IL 62526-1586
(217) 875-4222
Mailing address
602 N RUSSELL ST, CHAMPAIGN, IL 61821-2635
(217) 417-1458
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.028653
IL
Other
Enumeration date
06/15/2011
Last updated
12/10/2013
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