Individual
SHAHLA TAVANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1160 ARNOLD DR, MARTINEZ, CA 94553-6839
(925) 372-7100
Mailing address
1160 ARNOLD DR, MARTINEZ, CA 94553-6839
(925) 372-7100
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
23941
CA
Other
Enumeration date
12/19/2006
Last updated
07/08/2007
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