Individual
DR. CARLOS ALFONSO LOPEZ DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
31843 RANCHO CALIFORNIA RD STE 300, TEMECULA, CA 92591-5120
(951) 676-2613
Mailing address
30985 SAMANTHA LN, TEMECULA, CA 92592-2992
(951) 404-6661
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
101712
CA
122300000X
Dentist
DDS101712
CA
1223G0001X
General Practice Dentistry
DDS
CA
Other
Enumeration date
08/15/2017
Last updated
08/15/2017
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