Individual
JESSICA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12730 HAWTHORNE BLVD, SUITE D, HAWTHORNE, CA 90250-3919
(310) 644-4000
(310) 644-3232
Mailing address
1136 W FLORENCE AVE, LOS ANGELES, CA 90044-2508
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
09/09/2009
Last updated
09/09/2009
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