# IVORY DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275027591
- **Authorized official:** BENJAMIN HULL (OWNER/PRESIDENT)
- **Authorized official phone:** (208) 263-1412

## Contact information

- **Practice address:** 424 N. WARREN AVE., NEWPORT, WA 99156
- **Practice address phone:** (509) 447-5960
- **Mailing address:** 424 N. WARREN AVE., NEWPORT, WA 99156
- **Mailing address phone:** (509) 447-5960

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE60855077 | WA | Yes |

## Other

- **Enumeration date:** 06/20/2018
- **Last updated:** 06/20/2018