| Kokila Avasthi Dds Pc | |
|
401 S Greenleaf Ave Ste #3 Park City IL 60085-5744 | |
| (847) 662-8341 | |
| Not Available |
| Full Name | Kokila Avasthi Dds Pc |
|---|---|
| Speciality | Clinic/center |
| Location | 401 S Greenleaf Ave, Park City, Illinois |
| Authorized Official Name and Position | Kokila Avasthi (OWNER/DENTIST) |
| Authorized Official Contact | 8476628341 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kokila Avasthi Dds Pc 401 S Greenleaf Ave Ste 3 Park City IL 60085 Ph: (847) 662-8341 | Kokila Avasthi Dds Pc 401 S Greenleaf Ave Ste #3 Park City IL 60085-5744 Ph: (847) 662-8341 |
| NPI Number | 1346790565 |
|---|---|
| Provider Enumeration Date | 10/12/2016 |
| Last Update Date | 10/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346790565 | NPI | - | NPPES |
| 1114091303 | Other | IL | INDIVIUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 019022366 (Illinois) | Primary |
Greenleaf Medical Associates S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 401 Greenleaf Ave, 1, Park City, IL 60085 Phone: 847-662-0978 Fax: 847-662-1395 |