Organization
AFFINITY DENTAL CHAMPAIGN LLC
Active
Other names
Affinity Family Dental Champaign
Organization subpart
No
Provider details
NPI number
Authorized official
SRINIVAS DURSHANAPALLI DDS (PRESIDENT)
(217) 298-7999
Entity
Organization
Contact information
Practice address
2918 CROSSING CT STE A, CHAMPAIGN, IL 61822-6100
(217) 298-7999
(217) 888-3899
Mailing address
2918 CROSSING CT STE A, CHAMPAIGN, IL 61822-6100
(217) 298-7999
(217) 888-3899
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
12/04/2023
Last updated
01/23/2024
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