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Organization
DENTAL DESIGN STUDIO LLC DBA IVORY DENTAL
Active
Organization
DENTAL DESIGN STUDIO LLC DBA IVORY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEAH WASHINGTON (OFFICE MANAGER)
(505) 897-6889
Entity
Organization
Contact information
Practice address
5920 WHITEMAN DR NW, ALBUQUERQUE, NM 87120-2198
(505) 897-6889
(505) 922-1319
Mailing address
5920 WHITEMAN DR NW, ALBUQUERQUE, NM 87120-2198
(505) 897-6889
(505) 922-1319
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD3583
STATE DENTAL LICENSE
NM
Enumeration date
05/10/2023
Last updated
08/26/2024
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