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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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