Individual
DR. MANUEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
280 CONCORD PKWY S STE 110A, CONCORD, NC 28027-2704
(704) 920-1070
(704) 920-1071
Mailing address
280 CONCORD PKWY S STE 110A, CONCORD, NC 28027-2704
(704) 920-1070
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7303
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8990177
—
NC
01
—
90177
BCBS
NC
Enumeration date
03/06/2007
Last updated
04/26/2012
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