Provider Demographics
NPI:1427115930
Name:ANDREW P INGEL DMD LLC
Entity type:Organization
Organization Name:ANDREW P INGEL DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:INGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:410-766-6112
Mailing Address - Street 1:325 HOSPITAL DRIVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061
Mailing Address - Country:US
Mailing Address - Phone:410-766-6112
Mailing Address - Fax:410-766-3851
Practice Address - Street 1:325 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 205
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061
Practice Address - Country:US
Practice Address - Phone:410-766-6112
Practice Address - Fax:410-766-3851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD11183261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental