| NPI | 1720589799 |
|---|---|
| Former Legal Business Name | RAFAEL LOPEZ |
| Entity Type | Organization |
| Authorized Contact | RAFAEL LOPEZ Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: 756269) |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2018-02-26 |