Tavallaei, D.m.d., Corporation
NPI #1134716939 in Granite Bay, California
Provider Information
- NPI Number
- 1134716939
- Entity Type
- Organization
- Organization Name
- Tavallaei, D.m.d., Corporation
- Primary Specialty
- Dentist
- Enumeration Date
- Dec 28, 2020
- Last Updated
- Aug 10, 2022
Practice Location
- Address
- 4060 DOUGLAS BLVD STE 110
- City
- Granite Bay
- State
- California
- ZIP Code
- 95746-5934
- Phone
- (916) 260-0646
Authorized Official
- Name
- MEGAN CASTILLO
- Title
- OPERATIONS MANAGER
- Phone
- (916) 781-6550
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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