Organization
TAVALLAEI, D.M.D., CORPORATION
Active
Other names
Make a Smile
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MONICA TAVALLAEI D.M.D. (OWNER)
(530) 368-3685
Entity
Organization
Contact information
Practice address
500 AUBURN FOLSOM RD, SUITE330, AUBURN, CA 95603
(530) 368-3685
(916) 983-9012
Mailing address
500 AUBURN FOLSOM RD, SUITE330, AUBURN, CA 95603
(530) 368-3685
(916) 983-9012
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
48036
CA
Other
Enumeration date
12/29/2006
Last updated
01/18/2011
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