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General NPI Number Information
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NPI Number | 1295551455
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Entity Type | Organization
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Legal Business Name | ILEM BRACES 4 LESS, INC.
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 1253 VINE ST. STE. 18
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City | LOS ANGELES
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State | CA
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Zip | 90038
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Country | US
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Telephone | 323-464-0489
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Fax |
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Provider Business Mailing Address
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Address Line | 5647 TRYON RD.
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City | LOS ANGELES
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State | CA
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Zip | 90068
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Country | US
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Telephone | 626-418-7545
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANK JOSEPH ILEM
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Credential | DDS
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Telephone | 323-464-0489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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