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1013623586
TAVALLAEI DMD CORP
PLACERVILLE, CA
NPI
1013623586
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Entity Type
Organization
Authorized Contact
MEGAN CASTILLO
Business Manager
916-781-6550
Organization Subpart ?
No
Primary Taxonomy
122300000X Dentist
Enumeration Date
2023-01-26
Last Update Date
2023-01-26
Business Address
TAVALLAEI DMD CORP
4363 GOLDEN CENTER DR # A
PLACERVILLE, CA 95667-6260
Phone number: 916-984-0304
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Mailing Address
TAVALLAEI DMD CORP
2260 E BIDWELL ST # 316
FOLSOM, CA 95630-3555
Phone number:
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