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Organization
TAVALLAEI DMD CORP
Active
Organization
TAVALLAEI DMD CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN CASTILLO (OPERATIONS MANAGER)
(916) 781-6550
Entity
Organization
Contact information
Practice address
7803 MADISON AVE BLDG C SUITE 700A, CITRUS HEIGHTS, CA 95610
(916) 306-0333
Mailing address
2260 E BIDWELL ST # 314, FOLSOM, CA 95630-3555
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/23/2022
Last updated
08/24/2022
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