Organization
ANDREK J INGERSOLL DENTAL CORPORATION
Active
Other names
Shasta Kids Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDY JEFFREY INGERSOLL DMD (MANAGER)
(530) 579-1722
Entity
Organization
Contact information
Practice address
2775 PARK MARINA DR STE A, REDDING, CA 96001-2840
(919) 656-3004
Mailing address
3300 N TRIUMPH BLVD STE 100, LEHI, UT 84043-5046
(801) 494-4949
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
10/27/2020
Last updated
04/29/2021
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