Organization
INGRAM MALL FDC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN ARMSTRONG (REGIONAL MANAGER)
(505) 328-4867
Entity
Organization
Contact information
Practice address
6301 N.W. LOOP 410, STE L1A, SAN ANTONIO, TX 78238-3824
(210) 354-4867
(210) 681-6985
Mailing address
6301 N.W. LOOP 410, STE L1A, SAN ANTONIO, TX 78238-3824
(210) 354-4867
(210) 681-6985
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0008481
TX
Other
Enumeration date
05/23/2008
Last updated
05/23/2008
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