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Tavallaei, D.m.d., Corporation
Pediatric Dentist in Fairfield, California
NPI 1740795657

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 Fairfield, CA. The NPI Number for Tavallaei, D.m.d., Corporation is 1740795657 and holds a License No. 48036 (California).

The current practice location address for Tavallaei, D.m.d., Corporation is 1955 W Texas St Ste 2A, Fairfield, CA and can be reached out via phone at 916-707-7973.

Location: 1955 W Texas St Ste 2A, Fairfield, CA, 95630-3555
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1740795657
Provider Name
Tavallaei, D.m.d., Corporation
Credential
Provider Entity Type
Organization
Address
1955 W Texas St Ste 2A, Fairfield, CA, 95630-3555
Phone Number
916-707-7973
Fax Number
Provider Enumeration Date
12/14/2017
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1955 W Texas St Ste 2A
City
Fairfield
State
California
Zip
94533-4462
Phone Number
916-707-7973
Fax Number
person
Provider Business Mailing Address Details
Address
1955 W Texas St Ste 2A
City
Fairfield
State
California
Zip
94533-4462
Phone Number
916-707-7973
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
48036 (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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