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1255842340
STEPHEN BERTRAM INGRAM
LEBANON, PA
NPI
1255842340
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: PA DS020047L)
Enumeration Date
2017-10-17
Last Update Date
2018-03-17
Business Address
STEPHEN BERTRAM INGRAM DMD
710 S 12TH ST
LEBANON, PA 17042-6901
Phone number: 717-274-2913
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Mailing Address
STEPHEN BERTRAM INGRAM DMD
710 S 12TH STREET
LEBANON, PA 17042
Phone number: 717-274-2913
Copy
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