Provider Demographics
NPI:1760795785
Name:PUNIA, KOKILA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KOKILA
Middle Name:
Last Name:PUNIA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 BLOSSOM CIR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08810-2414
Mailing Address - Country:US
Mailing Address - Phone:678-428-4244
Mailing Address - Fax:
Practice Address - Street 1:1309 BLOSSOM CIR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:NJ
Practice Address - Zip Code:08810-2414
Practice Address - Country:US
Practice Address - Phone:678-428-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI024474001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice