Andrekgbortho Ingersoll Dental Corporation
NPI #1356216907 in Granite Bay, California
Provider Information
- NPI Number
- 1356216907
- Entity Type
- Organization
- Organization Name
- Andrekgbortho Ingersoll Dental Corporation
- Primary Specialty
- Dentist - Orthodontics and Dentofacial Orthopedics
- Enumeration Date
- Oct 6, 2025
- Last Updated
- Oct 6, 2025
Practice Location
- Address
- 4150 DOUGLAS BLVD STE B
- City
- Granite Bay
- State
- California
- ZIP Code
- 95746-5908
- Phone
- (916) 774-6986
Authorized Official
- Name
- LEEANN BLAZER
- Title
- DIRECTOR OF OPERATIONS
- Phone
- (707) 673-7531
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics |
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