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Organization

LILI MIRTORABI, D.D.S., M.S., A PROFESSIONAL CORPORATION

Active
Other names
Lili Mirtorabi Orthodontics
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LILI MIRTORABI (OWNER)
(310) 978-4746
Entity
Organization

Contact information

Practice address
11008 VALLEY MALL UNIT 203, EL MONTE, CA 91731-2645
(626) 279-9992
Mailing address
7722 SEVILLE AVE, HUNTINGTON PARK, CA 90255-6316

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 LICENSE
CA
Enumeration date
02/12/2010
Last updated
02/12/2010
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