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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