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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