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Organization

FOULADI PROFESSIONAL DENTAL CORP.

Active
Parent organization
FOULADI PROFESSIONAL DENTAL CORP.
Other names
Sacramento Oral Surgery South
Organization subpart
Yes

Provider details

NPI number
Legal business name
FOULADI PROFESSIONAL DENTAL CORP.
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization

Contact information

Practice address
7551 TIMBERLAKE WAY STE 120, SACRAMENTO, CA 95823-5421
(916) 423-4092
(916) 423-3125
Mailing address
7551 TIMBERLAKE WAY STE 120, SACRAMENTO, CA 95823-5421
(916) 423-4092
(916) 423-3125

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Enumeration date
04/08/2022
Last updated
04/08/2022
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