Organization
MARVIS SORRELL, D.M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIS YVONNE SORRELL DMD, MDS (PRESIDENT)
(562) 427-1426
Entity
Organization
Contact information
Practice address
4301 ATLANTIC AVE, SUITE 3, LONG BEACH, CA 90807-2833
(562) 427-1426
Mailing address
2317 PROMONTORY DR, SIGNAL HILL, CA 90755-3859
(562) 201-2929
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
31711
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31711
CALIFORNIA DENTAL LICENSE
CA
Enumeration date
02/07/2014
Last updated
02/07/2014
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