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NPI Code Detail

MEDICARE: DR. LARRY ANTHONY LOPEZ DDS

MEDICARE:  DR. LARRY ANTHONY LOPEZ  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry11660TX

General Provider Information

NPI Number : 1124138094
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY ANTHONY LOPEZ DDS
Provider Business Mailing Address
First Line : 1100 NW LOOP 410
Second Line : SUITE 511
City : SAN ANTONIO
State : TX
Zip : 78213-2263
Country : US
Telephone Number : 210-308-7008
Fax Number : 210-308-7379
Provider Business Practice Location Address
First Line : 1100 NW LOOP 410
Second Line : SUITE 511
City : SAN ANTONIO
State : TX
Zip : 78213-2263
Country : US
Telephone Number : 210-308-7008
Fax Number : 210-308-7379
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 07/08/2007

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Directions to “ DR. LARRY ANTHONY LOPEZ DDS” Practice Location

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