Individual
DR. VIVIAN FERNANDE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2821 TELEGRAPH AVE, BERKELEY, CA 94705-1118
(510) 848-4430
(510) 845-3834
Mailing address
2821 TELEGRAPH AVE, BERKELEY, CA 94705-1118
(510) 848-4430
(510) 845-3834
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
29355
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B29355
—
CA
Enumeration date
03/09/2007
Last updated
07/09/2007
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