Organization
IVY 2 DENTAL, PLLC
Active
Parent organization
IVY 2 DENTAL, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
IVY 2 DENTAL, PLLC
Authorized official
UMAR M IMTIAZ DDS (ASSOCIATE PROVIDER)
(623) 444-9999
Entity
Organization
Contact information
Practice address
4140 E 22ND ST, TUCSON, AZ 85711-5335
(623) 444-9999
(623) 444-6745
Mailing address
23374 W YUMA RD STE 102, BUCKEYE, AZ 85326-3120
(623) 444-9999
(623) 444-6745
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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