Individual
NANCY LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
16164 EBONY AVE, MORENO VALLEY, CA 92551-9228
(951) 236-0260
Mailing address
16164 EBONY AVE, MORENO VALLEY, CA 92551-9228
(951) 236-0260
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
27777
CA
126800000X
Dental Assistant
Primary
67522
CA
Other
Enumeration date
06/10/2013
Last updated
08/26/2013
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