Matthew Listiyo, DMD

NPI #1104472778 in Ontario, California

Provider Information

NPI Number: 1104472778
Entity Type: Individual
Name: Matthew Listiyo, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Aug 10, 2019
Last Updated: Sep 19, 2019

Practice Location

Address: 1361 E 4TH ST
City: Ontario
State: California
ZIP Code: 91764-3035
Phone: (916) 420-3989

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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