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NPI Code Detail

MEDICARE: MICHAEL LOPEZ DDS

MEDICARE: MICHAEL 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 DentistryDD2683NM

General Provider Information

NPI Number : 1679559348
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL LOPEZ DDS
Provider Business Mailing Address
First Line : PO BOX 370
Second Line :
City : HATCH
State : NM
Zip : 87937-0370
Country : US
Telephone Number : 505-267-3088
Fax Number : 505-267-1747
Provider Business Practice Location Address
First Line : 4375 1ST ST
Second Line :
City : LIVERMORE
State : CA
Zip : 94551-4912
Country : US
Telephone Number : 650-580-1082
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2005
Last Update Date : 03/11/2020

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Directions to “ MICHAEL LOPEZ DDS” Practice Location

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