| Ivy Endotontic Group | |
|
12865 Main St Ste 201 Garden Grove CA 92840-8200 | |
| (714) 530-7888 | |
| (714) 530-1344 |
| Full Name | Ivy Endotontic Group |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 12865 Main St Ste 201, Garden Grove, California |
| Authorized Official Name and Position | Mary Junghyun Um (PRESIDENT) |
| Authorized Official Contact | 7145307888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivy Endotontic Group 12865 Main St Ste 201 Garden Grove CA 92840-8200 Ph: (714) 530-7888 | Ivy Endotontic Group 12865 Main St Ste 201 Garden Grove CA 92840-8200 Ph: (714) 530-7888 |
| NPI Number | 1902542129 |
|---|---|
| Provider Enumeration Date | 05/10/2022 |
| Last Update Date | 05/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902542129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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