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MARK M INGRAM DMD

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1982758223

Individual Registrant:
 MARK M INGRAM DMD
Gender: M
Sole Proprietor

Location and contact information for practice:
1407 E UNION ST  VIENNA, GA 31092-7531 US
Tel: 229-268-6079  Fax: --

Contact information for business:
1407 E UNION ST  VIENNA, GA 31092-7531 US
Tel: 229-268-6079  Fax: --

Registration Information:
NPI: 1982758223
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
GA9355

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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