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General NPI Number Information
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NPI Number | 1902924053
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Entity Type | Organization
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Legal Business Name | INGLIS ORTHODONTICS, PLLC
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 45 WASHINGTON AVE E
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City | HUTCHINSON
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State | MN
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Zip | 55350-2574
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Country | US
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Telephone | 320-587-3502
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Fax | 320-587-0979
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Provider Business Mailing Address
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Address Line | PO BOX 665
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City | HUTCHINSON
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State | MN
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Zip | 55350-0665
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Country | US
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Telephone | 320-587-3502
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Fax | 320-587-0979
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS H INGLIS
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Credential | DDS
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Telephone | 320-587-3502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D8591
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License Number State | MN
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