# AUBURN AVENUE DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730687781
- **Authorized official:** DIPTI SRIVASTAVA DDSA (OWNER DENTIST)
- **Authorized official phone:** (253) 833-3680

## Contact information

- **Practice address:** 130 3RD ST NE, AUBURN, WA 98002-4013
- **Practice address phone:** (253) 833-3680
- **Practice address fax:** (253) 833-9581
- **Mailing address:** 130 3RD ST NE, AUBURN, WA 98002-4013
- **Mailing address phone:** (253) 833-3680
- **Mailing address fax:** (253) 833-9581

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DE60034827 | WA | Yes |

## Other

- **Enumeration date:** 01/24/2018
- **Last updated:** 01/24/2018