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Organization
TAIS TREVELIN DMD INC
Active
Organization
TAIS TREVELIN DMD INC
Active
Other names
Capri Dentistry, Poway Family Dental Center, Poway Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
TAIS TREVELIN LOWRY DMD (PRESIDENT)
(509) 508-7395
Entity
Organization
Contact information
Practice address
12378 POWAY RD STE B, POWAY, CA 92064-4242
(858) 679-8918
(858) 679-6993
Mailing address
12378 POWAY RD STE B, POWAY, CA 92064-4242
(858) 679-8918
(858) 679-6993
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/15/2023
Last updated
12/15/2023
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