| Ivy 2 Dental, Pllc | |
|
23374 W Yuma Rd Ste. 102 Buckeye AZ 85326-3118 | |
| (978) 328-2886 | |
| Not Available |
| Full Name | Ivy 2 Dental, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 23374 W Yuma Rd, Buckeye, Arizona |
| Authorized Official Name and Position | Umar Imtiaz (OWNER) |
| Authorized Official Contact | 9783282886 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivy 2 Dental, Pllc 23374 W Yuma Rd Ste. 102 Buckeye AZ 85326-3118 Ph: (978) 328-2886 | Ivy 2 Dental, Pllc 23374 W Yuma Rd Ste. 102 Buckeye AZ 85326-3118 Ph: (978) 328-2886 |
| NPI Number | 1588922272 |
|---|---|
| Provider Enumeration Date | 05/01/2012 |
| Last Update Date | 05/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588922272 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 7256 (Arizona) | Primary |
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