Individual
AUDREY NICOLE IMPERIAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
59 DG AF POSTGRADUATE DENTAL SCHOOL, 2133 PEPPERRELL ST BLDG 3352, JBSA - LACKLAND, TX 78236-5313
(210) 292-6258
Mailing address
1615 TRUEMPER ST, LACKLAND AFB, TX 78236-5511
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D010674
AZ
Other
Enumeration date
03/02/2020
Last updated
07/22/2025
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