Organization
LILI MIRTORABI, D.D.S., A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LILI MIRTORABI (OWNER)
(310) 978-4746
Entity
Organization
Contact information
Practice address
15106 HAWTHORNE BLVD, LAWNDALE, CA 90260-2136
(310) 978-4746
Mailing address
15106 HAWTHORNE BLVD, LAWNDALE, CA 90260-2136
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
42574
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42574
DENTAL/ORTHODONTICS
CA
Enumeration date
04/18/2008
Last updated
06/04/2015
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