Organization
MONIKA SRIVASTAVA DMD PA EAST
Active
Other names
JACARANDA SMILES CHILDREN'S DENTISTRY AND ORTHODONTICS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONIKA SRIVASTAVA DMD (OWNER/DENTIST)
(215) 485-7069
Entity
Organization
Contact information
Practice address
10051 PINES BLVD, SUITE C, PEMBROKE PINES, FL 33024-6186
(954) 251-2717
(954) 613-4005
Mailing address
10051 PINES BLVD STE D, PEMBROKE PINES, FL 33024-6172
(954) 251-2717
(954) 613-4005
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003557500
—
FL
Enumeration date
01/22/2016
Last updated
10/18/2024
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