| Vogue Dental Llc | |
|
305 S Linden St Ste 101 Normal IL 61761-4906 | |
| (309) 448-8889 | |
| Not Available |
| Full Name | Vogue Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 305 S Linden St Ste 101, Normal, Illinois |
| Authorized Official Name and Position | Srinivas Durshanapalli (PRESEIDENT/OWNER) |
| Authorized Official Contact | 2032154687 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vogue Dental Llc 305 S Linden St Ste 101 Normal IL 61761-4906 Ph: () - | Vogue Dental Llc 305 S Linden St Ste 101 Normal IL 61761-4906 Ph: (309) 448-8889 |
| NPI Number | 1780109470 |
|---|---|
| Provider Enumeration Date | 08/03/2017 |
| Last Update Date | 09/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780109470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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