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Individual

DR. ASHOK KOTHARI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS, MDS

Contact information

Practice address
919 W 55TH ST, COUNTRYSIDE, IL 60525-6613
(708) 352-1658
(708) 352-1683
Mailing address
919 W. 55TH STREET, COUNTRYSIDE, IL 60525
(708) 352-1658
(708) 352-1683

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0190190008
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
021001268
IL

Other

Enumeration date
07/13/2015
Last updated
07/13/2015
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