ANGEL RAY LOPEZ

ELIZABETHTOWN, KY
NPI1790246015
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223P0221X Dentist, Pediatric Dentistry
(Licence: KY  10616)
Additional Taxonomies122300000X Dentist
(Licence: OH  30.026059)
1223G0001X Dentist, General Practice
(Licence: OH  30.026059)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2019-03-28
Last Update Date2021-06-08
Business Address
ANGEL RAY LOPEZ
151 DREXLER CIR
ELIZABETHTOWN, KY 42701-7843
Phone number: 270-942-1277
Mailing Address
ANGEL RAY LOPEZ
151 DREXLER CIR
ELIZABETHTOWN, KY 42701-7843
Phone number: 270-942-1277