| NPI | 1336985076 |
|---|---|
| Doing Business As | AFFINITY FAMILY DENTAL PEORIA |
| Entity Type | Organization |
| Authorized Contact | SRINIVAS DURSHANAPALLI President 203-215-4687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-07-02 |
| Last Update Date | 2024-11-05 |