| NPI | 1992008098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA TAVALLAEI Owner 916-374-7711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 48036) |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2011-01-18 |