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Organization
SERGIO M. LOPEZ, D.D.S.,P. L.L.C.
Active
Organization
SERGIO M. LOPEZ, D.D.S.,P. L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SERGIO M. LOPEZ D.D.S. (DENTIST)
(303) 513-5041
Entity
Organization
Contact information
Practice address
3102 W WATERS AVE, SUITE 101, TAMPA, FL 33614-2882
(813) 374-2441
(813) 513-2925
Mailing address
3102 W WATERS AVE, SUITE 101, TAMPA, FL 33614-2882
(813) 374-2441
(813) 513-2925
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
18229
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007861100
—
FL
05
—
013389200
—
FL
05
—
44821026
—
CO
Enumeration date
04/20/2010
Last updated
07/18/2016
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