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General NPI Number Information
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NPI Number | 1255408449
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Entity Type | Individual
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Provider Name | GLORIANA M LOPEZ DDS
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Gender | Female
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 12/08/2010
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Provider Practice Location Address
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Address Line | 2855 OVERSEAS HWY
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City | MARATHON
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State | FL
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Zip | 33050-2239
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Country | US
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Telephone | 305-743-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 224 29TH STREET OCEAN
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City | MARATHON
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State | FL
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Zip | 33050-2218
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Country | US
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Telephone | 512-970-4919
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17431
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN9664
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN009754
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License Number State | GA
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