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General NPI Number Information
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NPI Number | 1497932230
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Entity Type | Organization
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Legal Business Name | PATRICIA Y. LOPEZ DDS, INC.
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 01/23/2008
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Provider Practice Location Address
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Address Line | 675 S 2ND AVE
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City | COVINA
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State | CA
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Zip | 91723-3518
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Country | US
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Telephone | 626-938-0195
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Fax | 626-938-0193
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Provider Business Mailing Address
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Address Line | 675 S 2ND AVE
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City | COVINA
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State | CA
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Zip | 91723-3518
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Country | US
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Telephone | 626-938-0195
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Fax | 626-938-0193
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Authorized Official
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Title or Position | DENTIST
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Name | DR. PATRICIA Y. LOPEZ
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Credential | DDS
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Telephone | 626-938-0195
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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 | 55961
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License Number State | CA
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