Individual
DR. MARK MAJID TAVAKOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS., MS.
Contact information
Practice address
310 N CIVIC DR APT 501, WALNUT CREEK, CA 94596-3694
(925) 285-2125
Mailing address
310 N CIVIC DR APT 501, WALNUT CREEK, CA 94596-3694
(925) 285-2125
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
39568
CA
Other
Enumeration date
10/09/2018
Last updated
05/10/2022
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