Affinity Dental Peoria LLC

NPI #1336985076 in Peoria, Illinois

Provider Information

NPI Number: 1336985076
Entity Type: Organization
Organization Name: Affinity Dental Peoria LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 2, 2024
Last Updated: Nov 5, 2024

Practice Location

Address: 3510 N UNIVERSITY ST STE C
City: Peoria
State: Illinois
ZIP Code: 61604-1348
Phone: (309) 271-7777

Authorized Official

Name: SRINIVAS DURSHANAPALLI
Title: PRESIDENT
Phone: (203) 215-4687

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X
Dentist - General Practice — General Practice	1223G0001X	Primary

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