# AFFINITY FAMILY DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Affinity Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790496776
- **Authorized official:** SRINIVAS DURSHANAPALLI DDS (PRESIDENT)
- **Authorized official phone:** (217) 303-5955

## Contact information

- **Practice address:** 2158 INTELLIPLEX DR STE 114, SHELBYVILLE, IN 46176-8549
- **Practice address phone:** (317) 392-3231
- **Mailing address:** 2158 INTELLIPLEX DR STE 114, SHELBYVILLE, IN 46176-8549
- **Mailing address phone:** (317) 392-3231

## Taxonomy

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

## Other

- **Enumeration date:** 12/09/2022
- **Last updated:** 12/09/2022