| Tavallaei Dmd Corp | |
|
731 Sterling Pkwy Suite 100 Lincoln CA 95648-7306 | |
| (916) 258-7639 | |
| (916) 983-9012 |
| Full Name | Tavallaei Dmd Corp |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 731 Sterling Pkwy, Lincoln, California |
| Authorized Official Name and Position | Monica Tavallaei (OWNER) |
| Authorized Official Contact | 9162587639 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tavallaei Dmd Corp 2260 E Bidwell St Suite 310 Folsom CA 95630-3463 Ph: (916) 258-7639 | Tavallaei Dmd Corp 731 Sterling Pkwy Suite 100 Lincoln CA 95648-7306 Ph: (916) 258-7639 |
| NPI Number | 1417399502 |
|---|---|
| Provider Enumeration Date | 07/18/2013 |
| Last Update Date | 08/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417399502 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 48036 (California) | Primary |
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