| Tais Trevelin Dmd Inc | |
|
12378 Poway Rd Ste B Poway CA 92064-4242 | |
| (858) 679-8918 | |
| (858) 679-6993 |
| Full Name | Tais Trevelin Dmd Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12378 Poway Rd Ste B, Poway, California |
| Authorized Official Name and Position | Tais Trevelin Lowry (PRESIDENT) |
| Authorized Official Contact | 5095087395 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tais Trevelin Dmd Inc 12378 Poway Rd Ste B Poway CA 92064-4242 Ph: (858) 679-8918 | Tais Trevelin Dmd Inc 12378 Poway Rd Ste B Poway CA 92064-4242 Ph: (858) 679-8918 |
| NPI Number | 1497523732 |
|---|---|
| Provider Enumeration Date | 12/15/2023 |
| Last Update Date | 12/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497523732 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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