Organization
AVILA DENTAL PC
Active
Parent organization
BERWYN DENTAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
BERWYN DENTAL GROUP
Authorized official
DR. VICTORIANO AVILA DDS (DENTIST)
(312) 404-4041
Entity
Organization
Contact information
Practice address
6144 S PULASKI RD, CHICAGO, IL 60629-4628
(773) 585-8000
(773) 585-8001
Mailing address
6144 S PULASKI RD, CHICAGO, IL 60629-4628
(773) 585-8000
(773) 585-8001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
01/06/2016
Last updated
07/21/2022
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