INGERSOLL PARK MARINA GP DENTAL CORPORATION NPI 1316547524

NPI Information

NPI: 1316547524
Provider Name: INGERSOLL PARK MARINA GP DENTAL CORPORATION
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
2301 PARK MARINA DR STE 27
REDDING, CA
ZIP 96001
Phone: (801) 494-4949
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INGERSOLL PARK MARINA GP DENTAL CORPORATION is a dental clinic center in Redding, CA. INGERSOLL PARK MARINA GP DENTAL CORPORATION NPI is 1316547524. The provider is registered as an organization entity type.

The provider's business location address is:

2301 PARK MARINA DR STE 27
REDDING, CA
ZIP 96001-158
Phone: (801) 494-4949

The provider's authorized official is Andrek Jeffrey Ingersoll .
The authorized official title is Manager and has the following contact phone number (919) 656-3004.

The enumeration date for this NPI number is 10/27/2020 and was last updated on 10/27/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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