# KOKILA AVASTHI DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346790565
- **Authorized official:** DR. KOKILA AVASTHI DDS (OWNER/DENTIST)
- **Authorized official phone:** (847) 662-8341

## Contact information

- **Practice address:** 401 S GREENLEAF AVE, STE \#3, PARK CITY, IL 60085-5744
- **Practice address phone:** (847) 662-8341
- **Mailing address:** 401 S GREENLEAF AVE, STE 3, PARK CITY, IL 60085
- **Mailing address phone:** (847) 662-8341

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 019022366 | IL | Yes |

## Other

- **Enumeration date:** 10/12/2016
- **Last updated:** 10/12/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1114091303 | INDIVIUAL NPI | IL |