Healthcare Provider Details

I. General information

NPI: 1083485031
Provider Name (Legal Business Name): MARCELO E LOPEZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 MARKET WAY RD
ARGYLE TX
76226-4896
US

IV. Provider business mailing address

1042 MARKEY WAY
ARGYLE TX
76226-4896
US

V. Phone/Fax

Practice location:
  • Phone: 940-294-0033
  • Fax:
Mailing address:
  • Phone: 940-294-0033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number42420
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: