Organization
CARLOS LOPEZ DIAZ DDS DENTAL CORPORATION
Active
Parent organization
CARLOS LOPEZ DIAZ DDS DENTAL CO
Other names
SMY Life Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
CARLOS LOPEZ DIAZ DDS DENTAL CO
Authorized official
DR. CARLOS LOPEZ DIAZ DDS (PRESIDENT)
(226) 200-1900
Entity
Organization
Contact information
Practice address
19046 LA PUENTE RD, WEST COVINA, CA 91792
(626) 200-1900
Mailing address
19046 LA PUENTE RD, WEST COVINA, CA 91792
(626) 200-1900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
101712
CA
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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