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NPI Code Detail

MEDICARE: DR. MANUEL LOPEZ D.D.S.

MEDICARE:  DR. MANUEL  LOPEZ  D.D.S.
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 Dentistry7303NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
290177OTHERNCBCBS

General Provider Information

NPI Number : 1326178518
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MANUEL LOPEZ D.D.S.
Provider Business Mailing Address
First Line : 280 CONCORD PKWY S STE 110A
Second Line :
City : CONCORD
State : NC
Zip : 28027-2704
Country : US
Telephone Number : 704-920-1070
Fax Number :
Provider Business Practice Location Address
First Line : 280 CONCORD PKWY S STE 110A
Second Line :
City : CONCORD
State : NC
Zip : 28027-2704
Country : US
Telephone Number : 704-920-1070
Fax Number : 704-920-1071
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 04/26/2012

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Directions to “ DR. MANUEL LOPEZ D.D.S.” Practice Location

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