Vogue Dental LLC

NPI #1780109470 in Normal, Illinois

Provider Information

NPI Number: 1780109470
Entity Type: Organization
Organization Name: Vogue Dental LLC
Primary Specialty: Dentist
Enumeration Date: Aug 3, 2017
Last Updated: Sep 17, 2020

Practice Location

Address: 305 S LINDEN ST STE 101
City: Normal
State: Illinois
ZIP Code: 61761-4906
Phone: (309) 448-8889

Authorized Official

Name: DR. SRINIVAS DURSHANAPALLI
Title: PRESEIDENT/OWNER
Phone: (203) 215-4687

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X
Dentist	122300000X	Primary

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