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Organization
FOULADI PROFESSIONAL DENTAL CORP.
Active
Organization
FOULADI PROFESSIONAL DENTAL CORP.
Active
Parent organization
FOULADI PROFESSIONAL DENTAL CORP.
Other names
Sacramento Oral Surgery South
Organization subpart
Yes
Provider details
NPI number
Legal business name
FOULADI PROFESSIONAL DENTAL CORP.
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
7551 TIMBERLAKE WAY STE 120, SACRAMENTO, CA 95823-5421
(916) 423-4092
(916) 423-3125
Mailing address
7551 TIMBERLAKE WAY STE 120, SACRAMENTO, CA 95823-5421
(916) 423-4092
(916) 423-3125
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
04/08/2022
Last updated
04/08/2022
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