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Organization
LI DDS DENTAL INC.
Active
Organization
LI DDS DENTAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JINGJING LI D.D.S. (CEO)
(909) 869-1098
Entity
Organization
Contact information
Practice address
3333 S BREA CANYON RD STE 121, DIAMOND BAR, CA 91765-3783
(909) 869-1098
(909) 869-7202
Mailing address
3333 S BREA CANYON RD STE 121, DIAMOND BAR, CA 91765-3783
(909) 869-1098
(909) 869-7202
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
56851
CA
1223P0300X
Periodontics
56851
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
46308
CA
Other
Enumeration date
02/15/2016
Last updated
08/01/2016
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