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Organization
OLIVE BRANCH DENTAL-2 LLC
Active
Organization
OLIVE BRANCH DENTAL-2 LLC
Active
Other names
Olive Branch Dental Columbus
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRINIVAS DURSHANAPALI DDS (PRESIDENT)
(217) 303-5955
Entity
Organization
Contact information
Practice address
2459 W JONATHAN MOORE PIKE, COLUMBUS, IN 47201-9206
(812) 516-5777
(812) 531-1177
Mailing address
2459 W JONATHAN MOORE PIKE, COLUMBUS, IN 47201-9206
(812) 516-5777
(812) 531-1177
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/07/2022
Last updated
01/07/2022
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