Organization
OLIVE BRANCH DENTAL LLC
Active
Other names
Olive Branch Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRINIVAS DURSHANAPALLI DDS (MANAGING PARTNER)
(217) 303-5955
Entity
Organization
Contact information
Practice address
2826 S STATE ROAD 135 STE C, GREENWOOD, IN 46143-9603
(317) 743-7777
(317) 854-6577
Mailing address
2826 S STATE ROAD 135 STE C, GREENWOOD, IN 46143-9603
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/17/2021
Last updated
03/03/2021
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