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Organization
UM DENTAL INC
Active
Organization
UM DENTAL INC
Active
Other names
IVY ENDOTONTIC GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY UM DDS (PRESIDENT)
(248) 943-2307
Entity
Organization
Contact information
Practice address
4040 BARRANCA PKWY STE 135A, IRVINE, CA 92604-4773
(949) 262-1300
(949) 262-0453
Mailing address
4040 BARRANCA PKWY STE 135A, IRVINE, CA 92604-4773
(949) 262-1300
(949) 262-0453
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107104
DENTIST
CA
Enumeration date
12/14/2021
Last updated
05/10/2022
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