| NPI | 1538828678 |
|---|---|
| Doing Business As | INGERSOLL FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | BERNARD LAWRENCE GRADOVILLE Owner 515-243-2412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2021-12-16 |