Individual
DIVYA AGARWAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
145 E 19TH ST STE A, COSTA MESA, CA 92627
(949) 650-1414
(949) 891-0409
Mailing address
145 E 19TH ST STE A, COSTA MESA, CA 92627-2877
(949) 650-1414
(949) 891-0409
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
58641
CA
Other
Enumeration date
06/27/2008
Last updated
09/16/2019
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