DR. Ivy Bass Mitcham, DDS

NPI #1235238221 in Katy, Texas

Provider Information

NPI Number: 1235238221
Entity Type: Individual
Name: DR. Ivy Bass Mitcham, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Sep 22, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1575 W GRAND PARKWAY S #1200
City: Katy
State: Texas
ZIP Code: 77494
Phone: (281) 395-1700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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