Provider Demographics
NPI:1558736124
Name:ASPRER-BELTRAN, MEREDITH (DMD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:ASPRER-BELTRAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 ANTONINA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-1193
Mailing Address - Country:US
Mailing Address - Phone:707-643-4048
Mailing Address - Fax:707-643-4068
Practice Address - Street 1:91 ANTONINA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-1193
Practice Address - Country:US
Practice Address - Phone:707-643-4048
Practice Address - Fax:707-643-4068
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA429751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice