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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