| Make A Smile | |
|
2190 E. Bidwell St. Folsom CA 95630 | |
| (916) 984-0304 | |
| (916) 983-9012 |
| Full Name | Make A Smile |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2190 E. Bidwell St., Folsom, California |
| Authorized Official Name and Position | Monica Tavallaei (OWNER) |
| Authorized Official Contact | 9169840304 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Make A Smile 2190 E. Bidwell St. Folsom CA 95630 Ph: (916) 984-0304 | Make A Smile 2190 E. Bidwell St. Folsom CA 95630 Ph: (916) 984-0304 |
| NPI Number | 1538225503 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 08/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538225503 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 48036 (California) | Primary |
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