| NPI | 1730687781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIPTI SRIVASTAVA Owner Dentist 253-833-3680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE60034827) |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2018-01-24 |