DR. Matthew Liesen, DMD

NPI #1619350725 in Peoria, Illinois

Provider Information

NPI Number: 1619350725
Entity Type: Individual
Name: DR. Matthew Liesen, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Jul 7, 2015
Last Updated: Jul 7, 2021

Practice Location

Address: 4517 N ROCKWOOD DR
City: Peoria
State: Illinois
ZIP Code: 61615-3841
Phone: (309) 688-0121

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Dental Public Health — Dental Public Health	1223D0001X
Dentist - General Practice — General Practice	1223G0001X	Primary

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