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Organization
BRADLEY ELI LA OFFICE
Active
Organization
BRADLEY ELI LA OFFICE
Active
Parent organization
BRADLEY A. ELI DENTAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRADLEY A. ELI DENTAL CORPORATION
Authorized official
DR. BRADLEY ALLEN ELI DMD (CEO)
(844) 235-9881
Entity
Organization
Contact information
Practice address
1964 WESTWOOD BLVD STE 200, LOS ANGELES, CA 90025-8424
(844) 235-9881
(760) 436-5123
Mailing address
1964 WESTWOOD BLVD STE 200, LOS ANGELES, CA 90025-8424
(844) 235-9881
(760) 436-5123
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
1223X2210X
Orofacial Pain Dentistry
—
NULL
1223X2210X
Orofacial Pain Dentistry
—
—
Other
Enumeration date
05/23/2023
Last updated
08/24/2023
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