Individual
MONICA TAVALLAEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
2190 E BIDWELL ST, FOLSOM, CA 95630-6469
(916) 984-0304
(916) 983-9012
Mailing address
2190 E BIDWELL ST, FOLSOM, CA 95630-6469
(916) 984-0304
(916) 983-9012
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
48036
CA
Other
Enumeration date
05/17/2007
Last updated
06/05/2008
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