Organization
BADII LEE DENTAL CORPORATION, INC
Active
Other names
SMILE WIDE
Organization subpart
No
Provider details
NPI number
Authorized official
KIAVASH BADII DDS (OWNER/DIRECTOR)
(949) 364-0590
Entity
Organization
Contact information
Practice address
777 CORPORATE DR, SUITE 210, LADERA RANCH, CA 92694-2135
(949) 364-0590
Mailing address
777 CORPORATE DR, SUITE 210, LADERA RANCH, CA 92694-2135
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/18/2013
Last updated
03/30/2015
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