Organization
TAVALLAEI, D.M.D., CORPORATION
Active
Other names
Make a Smile
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA TAVALLAEI D.M.D. (OWNER)
(916) 374-7711
Entity
Organization
Contact information
Practice address
3433 ARDEN WAY, SACRAMENTO, CA 95825-2018
(916) 374-7711
Mailing address
3433 ARDEN WAY, SACRAMENTO, CA 95825-2018
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
48036
CA
Other
Enumeration date
12/10/2010
Last updated
01/18/2011
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