Individual
JADE RASHIDA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
24185 US HIGHWAY 27, LAKE WALES, FL 33859-7819
(863) 676-6200
Mailing address
3610 SW 165TH AVE, MIRAMAR, FL 33027-4513
(954) 662-4922
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN27169
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2022
Last updated
05/17/2023
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