| Ivory Dental, Llc | |
|
5920 Whiteman Dr Nw Albuquerque NM 87120 | |
| (505) 897-6889 | |
| (505) 922-1319 |
| Full Name | Ivory Dental, Llc |
|---|---|
| Speciality | Dentist |
| Location | 5920 Whiteman Dr Nw, Albuquerque, New Mexico |
| Authorized Official Name and Position | Brendon E Prestwich (DENTIST) |
| Authorized Official Contact | 5058976889 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivory Dental, Llc 5920 Whiteman Dr Nw Albuquerque NM 87120-2198 Ph: (505) 897-6889 | Ivory Dental, Llc 5920 Whiteman Dr Nw Albuquerque NM 87120 Ph: (505) 897-6889 |
| NPI Number | 1275964587 |
|---|---|
| Provider Enumeration Date | 12/12/2013 |
| Last Update Date | 12/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275964587 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD4010 (New Mexico) | Primary |
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