Individual
MR. JOSE LUIS LOPEZ-LOPEZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
AVE LOS PATRIOTAS KM 1.8, ZIENA PROFESSIONAL PLAZA SUITE #7, LARES, PR 00669
(787) 897-8106
Mailing address
PO BOX 795, LARES, PR 00669
(787) 897-8106
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2245
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042064
CRUZ AZUL
—
01
—
3107
INTERNATIONAL MED CARD
—
01
—
3513653
ACAA
—
01
—
42437LO
TRIPLE S
—
01
—
6690039
HUMANA
—
01
—
70163
PREFERRED MEDICARE CHOICE
—
Enumeration date
06/07/2006
Last updated
07/08/2007
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