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General NPI Number Information
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NPI Number | 1245694132
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Entity Type | Organization
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Legal Business Name | ERIC LOPEZ DDS, INC.
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 04/07/2016
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Provider Practice Location Address
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Address Line | 7540 READING RD
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City | CINCINNATI
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State | OH
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Zip | 45237-3233
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Country | US
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Telephone | 513-821-3118
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Fax | 513-821-5219
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Provider Business Mailing Address
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Address Line | 7540 READING RD
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City | CINCINNATI
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State | OH
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Zip | 45237-3233
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Country | US
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Telephone | 513-821-3118
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Fax | 513-821-5219
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC MANUEL LOPEZ
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Credential | D.D.S.
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Telephone | 513-257-8948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 21799
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License Number State | OH
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