Organization
MONIKA SRIVASTAVA DMD PA WEST
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)
(267) 909-9551
Entity
Organization
Contact information
Practice address
18503 PINES BLVD, SUITE 209, PEMBROKE PINES, FL 33029-1404
(954) 436-0502
(954) 436-0503
Mailing address
18503 PINES BLVD, SUITE 209, PEMBROKE PINES, FL 33029-1404
(954) 436-0502
(954) 436-0503
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
04/18/2017
Last updated
10/18/2024
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