Individual
GILBERTO LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1021 SOUTH 21ST ST, FORT SMITH, AR 72901-4007
(479) 434-4277
Mailing address
1021 SOUTH 21ST ST, FORT SMITH, AR 72901-4007
(479) 434-4277
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3501
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167615608
—
AR
Enumeration date
12/14/2006
Last updated
06/30/2008
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