JORDAN LEROY INGERSOLL

WAUKESHA, WI
NPI1710619226
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist General Practice
(Licence: WI  6001016-15)
Enumeration Date2022-06-24
Last Update Date2022-06-24
Business Address
DR. JORDAN LEROY INGERSOLL DDS
419 E BROADWAY
WAUKESHA, WI 53186-5082
Phone number: 262-549-6850
Mailing Address
DR. JORDAN LEROY INGERSOLL DDS
1221 N 62ND ST APT 207
WAUWATOSA, WI 53213-3077
Phone number: 308-440-4214
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