Organization · Type 2 NPI
Tavallaei, D.m.d., Corporation
Pediatric Dentistry · Fairfield, CA
NPI number
1740795657
Active
Practice location
1955 W Texas St Ste 2A
Fairfield, CA 94533-4462
Mailing address
2260 E Bidwell St # 311
Folsom, CA 95630-3555
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Dentistry Primary | 1223P0221X | 48036 (CA) |
Pediatric Dentistry: 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.
Other pediatric dentistry providers in Fairfield
About NPI 1740795657
Tavallaei, D.m.d., Corporation's National Provider Identifier is 1740795657, issued on Dec 14, 2017. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Fairfield, CA. The record was last updated on Dec 15, 2017.