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Organization
TOOTH FAIRIES OF CALIFORNIA
Active
Organization
TOOTH FAIRIES OF CALIFORNIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRA YANG (DIRECTOR OF OPERATIONS)
(916) 502-7252
Entity
Organization
Contact information
Practice address
7915 LAGUNA BLVD STE 105, ELK GROVE, CA 95758-7945
(916) 502-7252
Mailing address
10373 GILLIAM DR, ELK GROVE, CA 95757-3512
(916) 502-7252
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
NULL
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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