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Tavallaei, D.m.d., Corporation
Pediatric Dentist in San Ramon, California
NPI 1386159879

Tavallaei, D.m.d., Corporation is a Pediatric Dentist based in Folsom, CA and is specialized in Pediatric Dentistry. Tavallaei, D.m.d., Corporation practices in San Ramon, CA. The NPI Number for Tavallaei, D.m.d., Corporation is 1386159879 and holds a License No. 1700020026 (California).

The current practice location address for Tavallaei, D.m.d., Corporation is 9130 Alcosta Blvd Ste A, San Ramon, CA and can be reached out via phone at 925-402-4141 and via fax at 916-983-9012.

Location: 9130 Alcosta Blvd Ste A, San Ramon, CA, 95630-3555
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1386159879
Provider Name
Tavallaei, D.m.d., Corporation
Credential
Provider Entity Type
Organization
Address
9130 Alcosta Blvd Ste A, San Ramon, CA, 95630-3555
Phone Number
925-402-4141
Fax Number
916-983-9012
Provider Enumeration Date
12/06/2017
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
9130 Alcosta Blvd Ste A
City
San Ramon
State
California
Zip
94583-3847
Phone Number
925-402-4141
Fax Number
916-983-9012
person
Provider Business Mailing Address Details
Address
9130 Alcosta Blvd Ste A
City
San Ramon
State
California
Zip
94583-3847
Phone Number
925-402-4141
Fax Number
916-983-9012
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
1700020026 (California)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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