| NPI | 1972264398 |
|---|---|
| Doing Business As | OLIVE BRANCH DENTAL COLUMBUS |
| Entity Type | Organization |
| Authorized Contact | SRINIVAS DURSHANAPALI President 217-303-5955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2022-01-07 |