Vogue Dental Peoria LLC

NPI #1265926729 in Peoria, Illinois

Provider Information

NPI Number: 1265926729
Entity Type: Organization
Organization Name: Vogue Dental Peoria LLC
Primary Specialty: Dentist
Enumeration Date: Jun 19, 2018
Last Updated: Feb 17, 2021

Practice Location

Address: 3510 N UNIVERSITY ST STE A
City: Peoria
State: Illinois
ZIP Code: 61604-1346
Phone: (203) 215-4687

Authorized Official

Name: DR. SRINIVAS R DURSHANAPALLI, DDS
Title: OWNER
Phone: (203) 215-4687

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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