Organization
INGERSOLL FAMILY DENTISTRY
Active
Other names
Ingersoll Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNARD LAWRENCE GRADOVILLE D.D.S. (OWNER)
(515) 243-2412
Entity
Organization
Contact information
Practice address
2800 INGERSOLL AVE, DES MOINES, IA 50312-4013
(515) 243-2412
Mailing address
2800 INGERSOLL AVE, DES MOINES, IA 50312-4013
(515) 243-2412
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/16/2021
Last updated
12/16/2021
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