Aqua Ingram Pllc
NPI #1942584040 in San Antonio, Texas
Provider Information
- NPI Number
- 1942584040
- Entity Type
- Organization
- Organization Name
- Aqua Ingram Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Oct 6, 2011
- Last Updated
- Oct 6, 2011
Practice Location
- Address
- 6064 INGRAM RD
- City
- San Antonio
- State
- Texas
- ZIP Code
- 78238-4402
- Phone
- (972) 677-7845
Authorized Official
- Name
- ANTONIO RIVERA
- Title
- MANAGING MEMBER
- Phone
- (972) 677-7845
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
| Dentist - General Practice — General Practice |
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