Organization
KEYVAN TAVAKOLI, DDS, MDS, P.A.
Active
Organization
KEYVAN TAVAKOLI, DDS, MDS, P.A.
Active
Other names
Valerian Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEYVAN TAVAKOLI DDS (PRESIDENT)
(910) 922-5707
Entity
Organization
Contact information
Practice address
18964 N DALE MABRY HWY STE 103, LUTZ, FL 33548-4913
(813) 591-1568
Mailing address
18964 N DALE MABRY HWY STE 103, LUTZ, FL 33548-4913
(813) 591-1568
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN22487
FL
Other
Enumeration date
06/06/2017
Last updated
07/21/2022
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