Provider Demographics
NPI:1508223009
Name:A AGARWAL DMD PLLC
Entity Type:Organization
Organization Name:A AGARWAL DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADITI
Authorized Official - Middle Name:
Authorized Official - Last Name:AGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-579-6641
Mailing Address - Street 1:5712 251ST CT NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-2559
Mailing Address - Country:US
Mailing Address - Phone:206-579-6641
Mailing Address - Fax:425-968-9850
Practice Address - Street 1:2001 8TH AVE # 130
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2615
Practice Address - Country:US
Practice Address - Phone:206-579-6641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00009797122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty