Healthcare Provider Details

I. General information

NPI: 1497922033
Provider Name (Legal Business Name): LI & LIM DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 03/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73950 ALESSANDRO DR SUITE #6
PALM DESERT CA
92260-3637
US

IV. Provider business mailing address

73950 ALESSANDRO DR SUITE #6
PALM DESERT CA
92260-3637
US

V. Phone/Fax

Practice location:
  • Phone: 760-340-3341
  • Fax: 760-340-1088
Mailing address:
  • Phone: 760-340-3341
  • Fax: 760-340-1088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number48499
License Number StateCA

VIII. Authorized Official

Name: DR. DAVID Z LI
Title or Position: OWNER
Credential: D.M.D.
Phone: 760-340-3341