# TENTH STREET FAMILY DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TENTH STREET FAMILY DENTAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720790991
- **Authorized official:** SRINIVAS DURSHANAPALLI DDS (PRESIDENT)
- **Authorized official phone:** (203) 215-4687

## Contact information

- **Practice address:** 6919 E 10TH ST STE A1, INDIANAPOLIS, IN 46219-4811
- **Practice address phone:** (317) 358-8885
- **Practice address fax:** (317) 358-8886
- **Mailing address:** 6919 E 10TH ST STE A1, INDIANAPOLIS, IN 46219-4811
- **Mailing address phone:** (317) 358-8885
- **Mailing address fax:** (317) 358-8886

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/20/2022
- **Last updated:** 12/20/2022