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NPI Code Detail

MEDICARE: EDUARDO C. LOPEZ, D.D.S., PC

MEDICARE: EDUARDO C. LOPEZ, D.D.S., PC
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
11223P0221XPediatric DentistryD9228OR

General Provider Information

NPI Number : 1972857746
Entity Type Code : Organization
Provider Name (Legal Business Name) : EDUARDO C. LOPEZ, D.D.S., PC
Provider Business Mailing Address
First Line : 9370 SW GREENBURG RD STE T
Second Line :
City : PORTLAND
State : OR
Zip : 97223-5408
Country : US
Telephone Number : 503-245-1915
Fax Number :
Provider Business Practice Location Address
First Line : 9370 SW GREENBURG RD STE T
Second Line :
City : PORTLAND
State : OR
Zip : 97223-5408
Country : US
Telephone Number : 503-245-1915
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. EDUARDO C LOPEZ
Credential : D.D.S.
Telephone Number : 503-245-1915
Provider Enumeration Date : 11/01/2012
Last Update Date : 11/01/2012

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Directions to “EDUARDO C. LOPEZ, D.D.S., PC ” Practice Location

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