Individual
DR. MICHAEL DOUGLAS LOPEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2257 JACKSBORO PIKE, LA FOLLETTE, TN 37766-2904
(423) 562-4766
(423) 562-3998
Mailing address
2257 JACKSBORO PIKE, LA FOLLETTE, TN 37766-2904
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9047
TN
Other
Enumeration date
07/20/2009
Last updated
07/20/2009
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