Individual
JENNIFER M LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
260 95TH ST, SUITE 202, SURFSIDE, FL 33154-2807
(305) 865-0453
Mailing address
260 95TH ST, SUITE 202, SURFSIDE, FL 33154-2807
(305) 865-0453
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21443
FL
Other
Enumeration date
04/02/2015
Last updated
11/18/2016
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