| Dipti Srivastava, Pllc | |
|
22619 Se 64th Pl Ste 210 Issaquah WA 98027-5342 | |
| (425) 369-9116 | |
| (425) 369-8997 |
| Full Name | Dipti Srivastava, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 22619 Se 64th Pl Ste 210, Issaquah, Washington |
| Authorized Official Name and Position | Dipti Srivastava (DENTIST) |
| Authorized Official Contact | 4253699116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dipti Srivastava, Pllc 22619 Se 64th Pl Ste 210 Issaquah WA 98027-5342 Ph: (425) 369-9116 | Dipti Srivastava, Pllc 22619 Se 64th Pl Ste 210 Issaquah WA 98027-5342 Ph: (425) 369-9116 |
| NPI Number | 1972058709 |
|---|---|
| Provider Enumeration Date | 08/22/2016 |
| Last Update Date | 08/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972058709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE60034827 (Washington) | Primary |
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