Provider Demographics
NPI:1679858062
Name:BELTRAN, ARTURO
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:
Last Name:BELTRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A AVE ENTRE 2DA Y 3RA
Mailing Address - Street 2:
Mailing Address - City:LOS ALGODONES
Mailing Address - State:BAJA CALIFORNIA
Mailing Address - Zip Code:21970
Mailing Address - Country:MX
Mailing Address - Phone:928-287-4736
Mailing Address - Fax:
Practice Address - Street 1:A AVE ENTRE 2DA Y 3RA
Practice Address - Street 2:
Practice Address - City:LOS ALGODONES
Practice Address - State:BAJA CALIFORNIA
Practice Address - Zip Code:21970
Practice Address - Country:MX
Practice Address - Phone:01152658-517-3499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ6247529122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist