Individual
BRENT K LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11615 ANGUS RD, SUITE 210, AUSTIN, TX 78759-4078
(512) 795-9643
(512) 795-9959
Mailing address
11615 ANGUS RD, SUITE 210, AUSTIN, TX 78759-4078
(512) 795-9643
(512) 795-9959
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
18694
TX
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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