| NPI | 1437640919 |
|---|---|
| Former Legal Business Name | STEPHANIE LOPEZ |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE LOPEZ Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ZZ 10214022) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-05-21 |