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General NPI Number Information
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NPI Number | 1730819293
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Entity Type | Individual
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Provider Name | JOSE ALBERTO LOPEZ-HERRERA DDS
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Gender | Male
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Dates
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Enumeration Date | 06/15/2022
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 10909 WEBB CHAPEL RD # 159
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City | DALLAS
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State | TX
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Zip | 75229-3739
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Country | US
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Telephone | 972-807-9887
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Fax |
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Provider Business Mailing Address
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Address Line | 1811 GREEN RIDGE DR
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City | CARROLLTON
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State | TX
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Zip | 75007-5203
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Country | US
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Telephone | 214-499-8066
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 38537
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License Number State | TX
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