Individual
DR. LUIS LORETTO CUELLAR III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2005 ROOSEVELT RD, SUITE B, VALPARAISO, IN 46383-2746
(219) 531-9293
(219) 531-0537
Mailing address
2005 ROOSEVELT RD, SUITE B, VALPARAISO, IN 46383-2746
(219) 531-9293
(219) 531-0537
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010544A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20044390
—
IN
Enumeration date
12/06/2006
Last updated
07/08/2007
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