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Organization

DR ANDREK GRANPED INGERSOLL DENTAL CORPORATION

Active
Other names
Bear Hollow Kids Dentistry - Granite Bay
Organization subpart
No

Provider details

NPI number
Authorized official
STACY KINGREY KINGREY (REGIONAL MANAGER)
(530) 356-4685
Entity
Organization

Contact information

Practice address
4150 DOUGLAS BLVD STE B, GRANITE BAY, CA 95746-5908
(916) 797-0931
Mailing address
4150 DOUGLAS BLVD STE B, GRANITE BAY, CA 95746-5908
(916) 797-0931

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
02/04/2026
Last updated
02/04/2026
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