Organization
BADII LEE DENTAL CORPORATION, INC.
Active
Other names
Smile Wide
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIAVASH KEVIN BADII 54538 (PRESIDENT)
(949) 596-8100
Entity
Organization
Contact information
Practice address
4024 12TH ST, RIVERSIDE, CA 92501-3561
(951) 784-0636
(951) 784-0675
Mailing address
1920 MAIN ST STE 970, IRVINE, CA 92614-8275
(949) 596-8100
(562) 424-9807
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
54538
CA
Other
Enumeration date
02/04/2015
Last updated
02/04/2015
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