Organization
DALLA DENTAL GROUP
Active
Other names
ORA DENTISTRY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEVAN DALLA DDS (PRESIDENT)
(646) 427-6519
Entity
Organization
Contact information
Practice address
2733 ELK GROVE BLVD, SUITE 180, ELK GROVE, CA 95758-7165
(916) 975-1000
Mailing address
2733 ELK GROVE BLVD, SUITE 180, ELK GROVE, CA 95758-7165
(916) 975-1000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
63130
CA
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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