Organization
OLIVE BRANCH DENTAL-1 LLC
Active
Other names
Olive Branch Dental Lafayette Rd
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRINIVAS DURSHANAPALLI DDS (PRESIDENT)
(217) 303-5955
Entity
Organization
Contact information
Practice address
5470 LAFAYETTE RD, INDIANAPOLIS, IN 46254-1620
(317) 643-7777
(317) 933-8454
Mailing address
5470 LAFAYETTE RD, INDIANAPOLIS, IN 46254-1620
(317) 643-7777
(317) 933-8454
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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