| Optim Dental LLC | |
|
907 S 6th St Springfield IL 62703-2401 | |
| (217) 971-3432 | |
| (217) 971-3462 |
| Full Name | Optim Dental LLC |
|---|---|
| Speciality | Dentist |
| Location | 907 S 6th St, Springfield, Illinois |
| Authorized Official Name and Position | Srinivas Durshanapalli (PRESIDENT) |
| Authorized Official Contact | 2032154687 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Optim Dental LLC 907 S 6th St Springfield IL 62703-2401 Ph: (217) 971-3432 | Optim Dental LLC 907 S 6th St Springfield IL 62703-2401 Ph: (217) 971-3432 |
| NPI Number | 1265820906 |
|---|---|
| Provider Enumeration Date | 01/05/2015 |
| Last Update Date | 01/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265820906 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019028802 (Illinois) | Primary |
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