Dr. Matthew Liesen, DMD
Dr. Matthew Liesen, DMD is a Public Health Dentistry in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2015.
- Licensed in
- IL
- In the registry since
- 2015
- Specialties on file
- 2
What do these letters mean?
- DMD — Doctor of Dental Medicine
- A dentist. Identical training and licensing to a DDS.
Practice location Address checks out
4517 N Rockwood DrPeoria, IL 61615-3841
Phone: (309) 688-0121
Fax: (309) 688-5643
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X · Licence 019030226 (IL) |
|---|---|
| Public Health Dentistry | Taxonomy 1223D0001X · Licence 019.030226 (IL) |
Record details
| NPI number | 1619350725 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | DMD |
| Sole proprietor | No |
| NPI enumerated | July 7, 2015 |
| Last updated in NPPES | July 7, 2021 |
| Certification date | July 7, 2021 |