Individual
GIL B IVRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
10833 LECONTE AVE, A0-156 CHS, LOS ANGELES, CA 90095-0001
(310) 825-0834
(310) 794-2198
Mailing address
2726 PACIFIC AVE, VENICE, CA 90291-4406
(805) 453-0951
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
59665
CA
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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