NPI | 1679313076 |
---|---|
Doing Business As | IVY ORTHODONTICS & FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | YASAS SHRI NALAKA JAYARATNE President 857-488-3009 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2024-05-31 |
Last Update Date | 2024-05-31 |