| Fouladi Professional Dental Corp. | |
|
1603 Eureka Rd Ste 100 Roseville CA 95661-3028 | |
| (916) 782-6868 | |
| (916) 782-6878 |
| Full Name | Fouladi Professional Dental Corp. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1603 Eureka Rd Ste 100, Roseville, California |
| Authorized Official Name and Position | Celia Hayes (CREDENTIALING COORDIANTOR) |
| Authorized Official Contact | 2175402100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fouladi Professional Dental Corp. 1603 Eureka Rd Ste 100 Roseville CA 95661-3028 Ph: (916) 782-6868 | Fouladi Professional Dental Corp. 1603 Eureka Rd Ste 100 Roseville CA 95661-3028 Ph: (916) 782-6868 |
| NPI Number | 1235871450 |
|---|---|
| Provider Enumeration Date | 04/08/2022 |
| Last Update Date | 04/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235871450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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