Individual
RAHUL SRIVASTAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
904 HAWTHORNE AVE, YPSILANTI, MI 48198-5812
(734) 709-4548
Mailing address
904 HAWTHORNE AVE, YPSILANTI, MI 48198-5812
(734) 709-4548
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901600581
MI
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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