MEDICARE: ARROYO-LOURENCO DENTAL CORPORATION

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	122300000X	Dentist	56298	CA

General Provider Information

NPI Number	:	1609237056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARROYO-LOURENCO DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	81800 DR CARREON BLVD STE D
Second Line	:
City	:	INDIO
State	:	CA
Zip	:	92201-0608
Country	:	US
Telephone Number	:	760-972-4705
Fax Number	:	760-972-4276

Provider Business Practice Location Address
First Line	:	81800 DR CARREON BLVD STE D
Second Line	:
City	:	INDIO
State	:	CA
Zip	:	92201-0608
Country	:	US
Telephone Number	:	760-972-4705
Fax Number	:	760-972-4276

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. AURY A LOURENCO
Credential	:	DDS
Telephone Number	:	714-373-1300

Provider Enumeration Date	:	03/14/2016
Last Update Date	:	05/09/2016

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Directions to “ARROYO-LOURENCO DENTAL CORPORATION ” Practice Location

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