| NPI | 1205960564 |
|---|---|
| Other Name | JUAN LOPEZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 052831-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 052831-1) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2018-04-25 |