Ivy 2 Dental Pllc

NPI #1760918965 in Glendale, Arizona

Provider Information

NPI Number: 1760918965
Entity Type: Organization
Organization Name: Ivy 2 Dental Pllc
Subpart: Yes (part of a larger organization)
Parent Organization: IVY 2 DENTAL PLLC
Primary Specialty: Dentist
Enumeration Date: May 8, 2017
Last Updated: Jul 20, 2021

Practice Location

Address: 17570 N 75TH AVE
Address 2: SUITE E500
City: Glendale
State: Arizona
ZIP Code: 85308-5999
Phone: (623) 322-9919

Authorized Official

Name: UMAR M IMTIAZ, DDS
Title: ASSOCIATE PROVIDER
Phone: (623) 444-9999

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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