Individual
GRISELDA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2712 JEFFERSON DAVIS HWY, #210, STAFFORD, VA 22554-1769
(703) 473-0925
Mailing address
16 PURI LN, STAFFORD, VA 22554-8201
(540) 720-8630
(540) 720-8632
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0402206670
VA
Other
Enumeration date
10/07/2016
Last updated
10/07/2016
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