Organization
AFFINITY DENTAL PEORIA HEIGHTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRINIVAS DURSHANAPALLI DDS (PRESIDENT)
(888) 244-8899
Entity
Organization
Contact information
Practice address
4450 N PROSPECT RD STE S5, PEORIA HEIGHTS, IL 61616-6578
(309) 327-3333
(309) 561-7333
Mailing address
4450 N PROSPECT RD STE S5, PEORIA HEIGHTS, IL 61616-6578
(309) 327-3333
(309) 561-7333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
05/05/2026
Last updated
05/05/2026
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