Individual
THAIS CARVALHO BOOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1258 COLOMA WAY, ROSEVILLE, CA 95661
(916) 784-1144
Mailing address
1258 COLOMA WAY, ROSEVILLE, CA 95661-4602
(916) 784-1144
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
2901018203
MI
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
54466
CA
Other
Enumeration date
07/18/2006
Last updated
05/19/2008
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