Healthcare Provider Details

I. General information

NPI: 1073427639
Provider Name (Legal Business Name): CLARICE LII DDS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3859 ROSEMEAD BLVD
ROSEMEAD CA
91770-1976
US

IV. Provider business mailing address

3859 ROSEMEAD BLVD
ROSEMEAD CA
91770-1976
US

V. Phone/Fax

Practice location:
  • Phone: 626-307-8600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: CLARICE LII
Title or Position: OWNER/DENTIST
Credential:
Phone: 626-625-3261