Organization
TAVALLAEI, D.M.D., CORPORATION
Active
Other names
Make a Smile
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONICA TAVALLAEI DMD (PEDIATRIC DENTIST)
(916) 380-0102
Entity
Organization
Contact information
Practice address
2241 SUNSET BLVD, SUITE D, ROCKLIN, CA 95765-4295
(916) 380-0102
(916) 983-9012
Mailing address
2241 SUNSET BLVD, SUITE D, ROCKLIN, CA 95765-4295
(916) 380-0102
(916) 983-9012
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
48036
CA
Other
Enumeration date
06/04/2008
Last updated
04/12/2016
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