Individual
LISET BELTRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1812 BROADWAY ST, MELROSE PARK, IL 60160-2039
(708) 498-4410
Mailing address
1812 BROADWAY ST, MELROSE PARK, IL 60160-2039
(708) 498-4410
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019029882
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2011
Last updated
03/17/2018
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