Individual
JENNIFER LOPES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3223 N BROAD ST, DEPARTMENT OF PERIODONTOLOGY AND ORAL IMPLANTOLOGY, PHILADELPHIA, PA 19140-5007
(215) 707-2926
Mailing address
3223 N BROAD ST, DEPARTMENT OF PERIODONTOLOGY AND ORAL IMPLANTOLOGY, PHILADELPHIA, PA 19140-5007
(215) 707-2926
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS040047
PA
Other
Enumeration date
10/10/2014
Last updated
10/10/2014
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