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Organization
SMILE 90210 LLC
Active
Organization
SMILE 90210 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM KALILI (DENTIST/OWNER)
(310) 273-6637
Entity
Organization
Contact information
Practice address
416 N BEDFORD DR, SUITE 102, BEVERLY HILLS, CA 90210-4322
(310) 273-6637
(310) 273-2138
Mailing address
416 N BEDFORD DR, SUITE 102, BEVERLY HILLS, CA 90210-4322
(310) 273-6637
(310) 273-2138
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
34503
MA
Other
Enumeration date
07/03/2012
Last updated
07/03/2012
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