| NPI | 1821757089 |
|---|---|
| Doing Business As | IVY ENDOTONTIC GROUP |
| Entity Type | Organization |
| Authorized Contact | MARY UM President 248-943-2307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2022-05-10 |