MEDICARE: A. A. LOURENCO, DDS, INC.

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
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1518583822
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A. A. LOURENCO, DDS, INC.

Provider Business Mailing Address
First Line	:	1978 SANTA FE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90810
Country	:	US
Telephone Number	:	562-912-4498
Fax Number	:	562-912-4496

Provider Business Practice Location Address
First Line	:	1978 SANTA FE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90810
Country	:	US
Telephone Number	:	562-912-4498
Fax Number	:	562-912-4496

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. AURY ARROYO LOURENCO
Credential	:	DDS
Telephone Number	:	305-323-1904

Provider Enumeration Date	:	06/23/2020
Last Update Date	:	06/23/2020

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