Dipti Srivastava, Pllc

NPI #1972058709 in Issaquah, Washington

Provider Information

NPI Number: 1972058709
Entity Type: Organization
Organization Name: Dipti Srivastava, Pllc
Primary Specialty: Dentist
Enumeration Date: Aug 22, 2016
Last Updated: Aug 22, 2016

Practice Location

Address: 22619 SE 64TH PL STE 210
City: Issaquah
State: Washington
ZIP Code: 98027-5342
Phone: (425) 369-9116

Authorized Official

Name: DIPTI SRIVASTAVA
Title: DENTIST
Phone: (425) 369-9116

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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