Individual
DIEGO ALFONSO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
11831 CULEBRA RD STE 101, SAN ANTONIO, TX 78253-4578
(210) 625-5353
Mailing address
8142 CACTUS BEND DR, SAN ANTONIO, TX 78254-4537
(210) 630-7160
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
38653
TX
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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