Optim Dental Llc

NPI 1265820906 - Dentist - 122300000X

NPI Details
NPI 1265820906
Enumeration Date 01/05/2015
Last Updated 01/05/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name SRINIVAS SRINIVAS
Position PRESIDENT
Phone (217) 971-3432
Fax (217) 971-3462
Practice Location
907 S 6TH ST
SPRINGFIELD IL, 62703-2401, US
Phone (217) 971-3432
Fax (217) 971-3462
Business Location
907 S 6TH ST
SPRINGFIELD IL, 62703-2401, US
Phone (217) 971-3432
Fax (217) 971-3462
Toxanomy
Taxonomy Code 122300000X
License State Illinois
License Number 019028802
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According to our database, Optim Dental Llc NPI is 1265820906, taxonomy code is 122300000X and license number is 019028802, license state is located at Illinois. Optim Dental Llc physically located at 907 S 6th St, Springfield IL, 62703-2401. NPI Number 1033115704 has the healthcare provider type.

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1265820906 NPI number is provided on an as is basis without warranty of any kind. 1265820906 is maintained by the National Plan & Provider Enumeration System. The contents of Optim Dental Llc are for informational purposes only.