Healthcare Provider Details

I. General information

NPI: 1265610802
Provider Name (Legal Business Name): LOPEZ AND STROMBERG DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2008
Last Update Date: 07/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20258 US HIGHWAY 18 SUITE 400
APPLE VALLEY CA
92307
US

IV. Provider business mailing address

2860 MICHELLE DRIVE 2ND FLOOR
IRVINE CA
92606-1008
US

V. Phone/Fax

Practice location:
  • Phone: 760-646-8839
  • Fax: 760-961-7252
Mailing address:
  • Phone: 714-508-3600
  • Fax: 714-368-2092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. LOUIS Z STROMBERG
Title or Position: OWNER DOCTOR
Credential: DDS
Phone: 760-646-8839