Individual
DR. LOURDES ELENTO BALQUIEDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3339 WEST 55TH STREET FRONT, CHICAGO, IL 60632
(773) 436-1236
Mailing address
3339 WEST 55TH STREET FRONT, CHICAGO, IL 60632
(773) 436-1236
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
12/19/2005
Last updated
07/08/2007
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