Organization
LILI MIRTORABI D.D.S A PROFESSIONAL CORPORATION
Active
Parent organization
LILI MIRTORABI, D.D.S., M.S., A PROFESSIONAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
LILI MIRTORABI, D.D.S., M.S., A PROFESSIONAL CORPORATION
Authorized official
GABRIELA VALDOVINOS (MANAGING DIRECTOR)
(323) 228-9282
Entity
Organization
Contact information
Practice address
2368 PICO BOULEVARD, LOS ANGELES, CA 90006
(844) 347-5794
Mailing address
7722 SEVILLE AVE, HUNTINGTON PARK, CA 90255-6316
(844) 347-5794
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020669521
ORTHODONTIST
CA
Enumeration date
09/20/2018
Last updated
02/08/2019
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