Individual
LAUREN SRIVASTAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
250 TIDE WAY, MORGANTOWN, WV 26508-1800
(484) 802-7238
Mailing address
250 TIDE WAY, MORGANTOWN, WV 26508-1800
(484) 802-7238
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
4643
WV
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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