Individual
DR. BRIAN LY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
293 N STATE COLLEGE BLVD, APT 1017, ORANGE, CA 92868-5700
(310) 658-0620
Mailing address
293 N STATE COLLEGE BLVD, APT 1017, ORANGE, CA 92868-5700
(310) 658-0620
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
100738
CA
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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