Individual
MARY LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.A.
Contact information
Practice address
1725 W 6TH ST, LOS ANGELES, CA 90017-1000
(213) 413-5151
Mailing address
557 S KERN AVE, LOS ANGELES, CA 90022-1813
(562) 544-8249
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
65878
CA
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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