Ingram Mall Fdc PA
NPI #1992963136 in San Antonio, Texas
Provider Information
- NPI Number
- 1992963136
- Entity Type
- Organization
- Organization Name
- Ingram Mall Fdc PA
- Primary Specialty
- Dentist
- Enumeration Date
- May 23, 2008
- Last Updated
- May 23, 2008
Practice Location
- Address
- 6301 N.W. LOOP 410
- Address 2
- STE L1A
- City
- San Antonio
- State
- Texas
- ZIP Code
- 78238-3824
- Phone
- (210) 354-4867
Authorized Official
- Name
- LYNN ARMSTRONG
- Title
- REGIONAL MANAGER
- Phone
- (505) 328-4867
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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