Organization
TAVALLAEI, D.M.D., CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN CASTILLO (OPERATIONS MANAGER)
(916) 781-6550
Entity
Organization
Contact information
Practice address
7227 29TH ST STE A, SACRAMENTO, CA 95822-5005
(916) 984-0304
(916) 983-9012
Mailing address
2260 E BIDWELL ST, #309, FOLSOM, CA 95630-3463
(916) 984-0304
(916) 983-9012
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
48036
CA
Other
Enumeration date
06/19/2015
Last updated
03/01/2023
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