Organization
BADII LEE DENTAL CORPORATION, INC
Active
Other names
Smile Wide
Organization subpart
No
Provider details
NPI number
Authorized official
KIAVASH KEVIN BADII DDS (PRESIDENT)
(714) 835-2383
Entity
Organization
Contact information
Practice address
22330 HAWTHORNE BLVD., SUITE 2016, TORRANCE, CA 90505
(310) 375-5801
(310) 375-6071
Mailing address
22330 HAWTHORNE BLVD., SUITE 2016, TORRANCE, CA 90505
(310) 375-5801
(310) 375-6071
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
54538
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
12/23/2009
Last updated
10/27/2015
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