Individual
JUAN CARLOS LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1201 NW 16TH ST, DENTAL SERVICE (160), VA MEDICAL CENTER, MIAMI, FL 33125-1624
(305) 575-3146
(305) 575-3373
Mailing address
1201 NW 16TH ST, DENTAL SERVICE (160), VA MEDICAL CENTER, MIAMI, FL 33125-1624
(305) 575-3146
(305) 575-3373
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN15576
FL
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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