Provider Demographics
NPI:1861544389
Name:BELTRONE, LOUIS J (DMD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:J
Last Name:BELTRONE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1869 NW 66TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-4017
Mailing Address - Country:US
Mailing Address - Phone:954-983-3992
Mailing Address - Fax:954-983-4006
Practice Address - Street 1:1869 NW 66TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-4017
Practice Address - Country:US
Practice Address - Phone:954-983-3992
Practice Address - Fax:954-983-4006
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0005977122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist