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Individual

MELIZA C QUESEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
450 DUNDEE AVE, ELGIN, IL 60120-4205
(847) 608-1334
(847) 608-6775
Mailing address
450 DUNDEE AVE, ELGIN, IL 60120-4205
(847) 608-1334
(847) 608-6775

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019027708
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019027708
IL
Enumeration date
09/23/2008
Last updated
09/23/2008
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